超低出生体重儿早发型脓毒症的临床特点  

Surveillance of Early-onset Sepsis in Extremely Low Birth Weight Infants

作　　者：戴海燕 梁亚峰[2] 李昌崇[2] 钱燕 王楸[1] 黄丽密[1] Dai Haiyan;Liang Yafeng;Li Changchong(Department of Neonatology,The First Affiliated Hospital,Wenzhou Medical University,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第一医院,325000 [2]温州医科大学附属第二医院,325000

出　　处：《医学研究杂志》2019年第3期62-65,共4页Journal of Medical Research

基　　金：浙江省医药卫生科技项目(2018264630)

摘　　要：目的了解超低出生体重儿早发型脓毒症的临床特点,以指导临床诊疗。方法对2006年1月～2017年12月笔者医院78例超低出生体重儿早发型脓毒症的临床特点进行回顾性分析。结果早发型脓毒症发生率为60. 5%,近6年显著升高(P <0. 01)。男性、26～28周胎龄、出生体重751～1000g患儿近6年比前6年早发型脓毒症的发生率上升,差异有统计学意义(P均<0. 05)。胎膜早破、产前使用抗生素、产前使用激素、性别、胎龄、出生体重、宫内生长受限与早发型脓毒症发病无显著关系。早发型脓毒症患儿第1天血白细胞计数<7. 0×10~9/L,血气分析p H值> 7. 45或<7. 25发生率显著升高(P均<0. 05)。血培养阳性率为20. 5%,以革兰阴性菌为主。结论超低出生体重儿早发型脓毒症发生率高,呈上升趋势,而血培养阳性率低。应采取各种积极措施来降低发生率,提高治愈率。Objective To investigate the clinical characteristics of early-onset sepsis among extremely low birth weight(ELBW)infants with early-onset sepsis(EOS),so as to guide clinical diagnosis and treatment.Methods We reviewed the medical records of ELBW infants born in our hospital between 2006 and 2017,and those of infants born between 2006 and 2011 were compared with those between 2012 to 2017.Results The incidence of early-onset sepsis was 60.5%,and the incidence was significantly higher in the last 6 years(P<0.01).The incidence of early-onset sepsis in infants of male,gestational age at 26-28 weeks and birth weight at 751-1000 g was significantly increased in the last 6 years(P was 0.014,0.042,0.000,respectively).Premature rupture of membranes,antenatal antibiotics,antenatal hormone,sex,gestational age,birth weight and intrauterine growth restriction were not risk factors for early-onset sepsis.The blood leucocyte count lower than 7.0×10^9/L or pH>7.45 or<7.25 in blood gas analysis of the first day birth was much more often seen in infants with early onset sepsis(both P<0.05).The positive rate of blood culture was 20.5%,which was mainly Gram-negative bacteria.Conclusion The incidence of early-onset sepsis in ELBW infants is high,and the positive rate of blood culture is low.All kinds of positive measures should be taken to reduce the incidence and improve the cure rate.

关 键 词：早发型脓毒症 超低出生体重儿 婴儿 危险因素 

分 类 号：R72[医药卫生—儿科]