早晚发新生儿败血症高危因素与局部感染发生率  

High risk factors and incidence of local infection of early and late onset neonatal sepeticemia

作　　者：胡冬梅[1] 陈梅[1] 于航 HU Dong-mei, CHEN Mei, YU Hang(Department of Pediatrics, PLA 202nd Hospital, Shenyang, Liaoning 110000, Chin)

机构地区：[1]解放军第202医院新生儿科,辽宁沈阳110000

出　　处：《热带医学杂志》2018年第3期380-382,391,共4页Journal of Tropical Medicine

摘　　要：目的分析早晚发新生儿败血症高危因素与局部感染发生率及各种病原菌感染。方法选取2013年5月至2016年5月本院收治的新生儿败血症患儿94例,其中早发新生儿败血症(出生7 d内发病)35例,晚发新生儿败血症(出生7 d后发病)59例。对住院资料进行回顾性分析统计,对常见高危因素、局部感染率和病原菌感染指标数据进行收集整理,总结分析新生儿败血症患儿高危因素、局部感染率和病原学特点。结果新生儿败血症高危因素主要是早产、胎膜早破、低出生体重、脐带绕颈、宫内窘迫、羊水发臭或粪染和生后窒息;新生儿败血症患儿中主要存在呼吸道感染、皮肤黏膜感染、化脓性脑膜炎等局部感染,晚发组患儿皮肤黏膜感染率高于早发组,差异有统计学意义(P<0.05);新生儿败血症患儿以革兰氏阳性菌感染为主,晚发组患儿革兰阳性菌感染率高于早发组,差异有统计学意义(P<0.05)。结论新生儿败血症的主要高危因素为早产及胎膜早破等,多伴随局部感染,病原菌以革兰氏阳性菌为主。Objective To analyze the high risk factors, the incidence of local infection and various pathogens infection of early and late onset neonatal sepeticemia. Method 94 cases of neonatal septicemia from May 2013 to May 2016 in our hospital were retrospectively analyzed , for common risk factors , local infection rate and pathogen infection index. Results The main risk factors of neonatal sepsis were premature, premature rupture of fetal membranes , low birth weight, umbilical cord around the neck, fetal distress, meconium stained amniotic fluid and stink or after birth asphyxia; there were local infection of respiratory tract infection, skin mucous membrane infection and purulent meningitis in children with neonatal sepsis. In the late-onset group, skin mucous membrane infection rate was significantly higher than that of the early- onset group （P〈0.05）. Neonatal sepsis in children was mainly caused by Gram- positive infections. The incidence of Gram-positive bacteria infection in late-onset group was significantly higher than that in early- onset group （P〈0.05）. Conclusions The main risk factors of neonatal sepsis were premature birth and premature rupture of membranes, and most of them were accompanied by local infection. The pathogens were mainly Gram positive bacteria.

关 键 词：新生儿败血症 高危因素 局部感染 病原菌感染 

分 类 号：R722.131[医药卫生—儿科]