新生儿败血症死亡病例的临床分析  

Clinical analysis of neonatal sepsis deaths

作　　者：颜慧恒[1] 李晖[2] 何倩敏[1] 王艳丽[1] 陈运彬[1] YAN Huiheng;LI Hui;HE Qianmin;WANG Yanli;CHEN Yunbin(Department of Neonatology,Guangdong Women and Children Hospital,Guangdong Province,Guangzhou510000,China;Department of Information Management,Guangdong Women and Children Hospital,Guangdong Province,Guangzhou510000,China)

机构地区：[1]广东省妇幼保健院新生儿科,广东广州510000 [2]广东省妇幼保健院信息管理科,广东广州510000

出　　处：《中国医药导报》2021年第23期84-87,103,共5页China Medical Herald

基　　金：广东省科技计划项目(2017ZC0322)。

摘　　要：目的分析早发败血症(EOS)及晚发败血症(LOS)新生儿死亡病例的临床特点。方法回顾性分析2016年1月至2020年12月广东省妇幼保健院新生儿科住院且死亡原因为新生儿败血症的病例资料。根据发病时间将其分为EOS组(38例)和LOS组(46例),比较两组的基本资料(性别、出生胎龄、出生体重、围生期相关因素)及临床特点(败血症相关检验结果、合并症的发生情况)。结果两组性别、出生胎龄、早产、出生体重、超低出生体重儿、小于胎龄儿、剖宫产比较,差异无统计学意义(P>0.05)。EOS组发病至死亡时间短于LOS组,差异有统计学意义(P<0.05)。两组胎膜早破≥18 h、羊水Ⅲ度污染、胎儿窘迫、母亲年龄>35岁、母亲绒毛膜羊膜炎、母亲孕后期感染发生率比较,差异无统计学意义(P>0.05)。EOS组肺炎克雷伯菌检出率低于LOS组;EOS组白细胞计数(WBC)<5×10^(9)/L、WBC升高发生率低于LOS组,差异有统计学意义(P<0.05)。两组血小板计数(PLT)<100×10^(9)/L、PLT≤30×10^(9)/L、C反应蛋白≥100 mg/L、降钙素原≥30 ng/ml发生率及B族链球菌、大肠埃希菌检出率比较,差异无统计学意义(P>0.05)。EOS组新生儿坏死性小肠结肠炎发生率低于LOS组,围生期窒息发生率高于LOS组,差异有统计学意义(P<0.05)。两组细菌性脑膜炎、感染性肺炎、新生儿高血糖症、新生儿低血糖症、新生儿肺出血发生率比较,差异无统计学意义(P>0.05)。结论新生儿期EOS和LOS导致死亡的高危因素不同、病原体不同、合并症也有差异,在临床工作应引起重视。Objective To analyze the clinical characteristics of neonatal deaths with early-onset sepsis(EOS)and late-onset sepsis(LOS).Methods Data of neonatal sepsis cases hospitalized in Department of Neonatology,Guangdong Women and Children Hospital from January 2016 to December 2020 were retrospectively analyzed.According to the time of onset,they were divided into EOS group(38 cases)and LOS group(46 cases).Basic data(gender,gestational age,birth weight,perinatal related factors)and clinical characteristics(sepsis related test results,the incidence of complications)were compared between two groups.Results There were no significant differences in gender,gestational age,preterm,birth weight,extremely low birth weight infant,small for gestational age,cesarean section between two groups(P>0.05).The time from onset to death in EOS group was shorter than that in LOS group,and the difference was statistically significant(P<0.05).There were no significant differences in the incidence of premature rupture of membranes≥18 h,Ⅲdegree contamination of amniotic fluid,fetal distress,maternal age>35 years old,maternal chorionic amniotis,and maternal infection in late pregnancy between two groups(P>0.05).The detection rate of Klebsiella pneumoniae in EOS group was lower than that in LOS group;white blood cell count(WBC)<5×10^(9)/L and the incidence of WBC increase in EOS group were lower than those in LOS group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of platelet count(PLT)<100×10^(9)/L,PLT≤30×10^(9)/L,C-reactive protein≥100 mg/L,procalcitonin≥30 ng/ml and detection rate of group B streptococcus,Escherichia coli between two groups(P>0.05).The incidence of neonatal necrotizing enterocolitis in EOS group was lower than that in LOS group,and the incidence of perinatal asphyxia was higher than that in LOS group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of bacterial meningitis,infectiou

关 键 词：早发败血症 晚发败血症 新生儿 死亡 

分 类 号：R722[医药卫生—儿科]