新生儿重症细菌性肺炎死亡相关危险因素分析  

Risk factors of mortality in neonates with severe bacterial pneumonia

作　　者：谢朝云[1] 熊芸[1] 孙静[1] 胡阳[1] XIE Zhaoyun;XIONG Yun;SUN Jing;HU Yang(The Third Affiliated Hospital, Guizhou Medical University, Duyun 558000, Guizhou, China)

机构地区：[1]贵州医科大学第三附属医院,贵州都匀558000

出　　处：《临床儿科杂志》2017年第7期512-515,共4页Journal of Clinical Pediatrics

基　　金：贵州省黔南州社会发展科技项目(No.黔南科合社字[2013]20号)

摘　　要：目的探讨新生儿重症细菌性肺炎的死亡危险因素。方法回顾分析2011年1月—2015年11月249例新生儿重症细菌性肺炎患儿的临床资料,分析死亡相关因素。结果 249例患儿中,死亡45例,病死率18.07%。细菌培养检出病原菌251株,前5位病原菌依次为大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌、肺炎链球菌及表皮葡萄球菌。单因素分析显示,死亡组与存活组的出生胎龄、胎膜早破、入院时日龄、出生体质量、喂养方式、Apgar评分、总胆红素值、并发症、创伤性治疗、肠外营养和多重耐药菌感染之间差异有统计学意义(P均<0.05)。多因素logistic回归分析显示,入院时日龄<7天(OR=4.30,95%CI:1.74~10.64)、Apgar评分<7分(OR=3.24,95%CI:1.23~8.49)、有并发症(OR=6.81,95%CI:2.65~17.46)、多重耐药菌感染(OR=6.16,95%CI:1.90~19.99)及创伤性治疗(OR=3.82,95%CI:1.03~14.16)是新生儿重症细菌性肺炎患儿死亡的独立危险因素(P均<0.05)。结论新生儿重症细菌性肺炎病死率较高,入院时日龄小、Apagar评分低、有并发症、多重耐药菌感染及创伤性治疗是死亡的主要危险因素。Objective To explore the risk factors of mortality in neonates with severe bacterial pneumonia.Method The clinical data of249neonates with severe bacterial pneumonia from January2011to November2015were analyzed retrospectively,and the related factors of mortality were analyzed.Results Of the249children,45died and mortality rate was18.07%.A total of251strains of pathogenic bacteria were detected in the bacterial culture,and the top5pathogens were Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae,Streptococcus pneumoniae and Staphylococcus epidermidis.Univariate analysis showed that the gestational age,premature rupture of membranes,age at the time of hospital admission,birth weight,feeding,Apgar score,total bilirubin,complications,traumatic treatment,parenteral nutrition,and multidrug-resistant bacteria infection between the death group and survival group were significantly different(all P<0.05).Multivariate logistic regression analysis showed that the age at admission<7days(OR=4.30,95%CI:1.74~10.64),Apgar scores<7(OR=3.24,95%CI:1.23~8.49),and having complications(OR=6.81,95%CI:2.65~17.46),multidrug-resistant bacteria infection(OR=6.16,95%CI:1.90~19.99)and traumatic therapy(OR=3.82,95%CI:1.03~14.16)were the independent risk factors of mortality in neonatal severe bacterial pneumonia(all P<0.05).Conclusion The mortality rate of neonatal severe bacterial pneumonia is relatively high.And the main risk factors of death were the age at admission<7days,Apgar scores<7,and having complications,multidrug-resistant bacteria infection and traumatic therapy.

关 键 词：重症肺炎 病死率 危险因素 新生儿 

分 类 号：R722.135[医药卫生—儿科]