NICU不同病原菌早产儿败血症临床特点分析  

Clinical characteristics of preterm infants with septicemia in NICU with different pathogens

作　　者：杨冬[1,2] 白瑞苗 赵迪 罗立倩 刘俐 YANG Dong;BAI Ruimiao;ZHAO Di;LUO Liqian;LIU Li(Department of Neonatology,the First Affiliated Hospital of Xi’an Jiaotong University,Shaanxi Xi'an 710061,China;Department of Neonatology,Northwest Women’s and Children’s Hospital,Shaanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院新生儿科,陕西西安710061 [2]西北妇女儿童医院新生儿科,陕西西安710061

出　　处：《中国妇幼健康研究》2022年第3期81-86,共6页Chinese Journal of Woman and Child Health Research

摘　　要：目的探讨革兰阴性菌、革兰阳性菌及真菌引起的早产儿败血症的临床特点。方法回顾性分析2015年1月1日至2019年12月31日入住西北妇女儿童医院新生儿重症监护病房(NICU)早产儿败血症184例,根据血培养结果,分为革兰阴性菌组、革兰阳性菌组及真菌组,比较不同病原菌所致早产儿败血症的临床特点。结果(1)血培养阳性的病原菌中,革兰阴性菌118株,占64.13%;革兰阳性菌45株,占24.45%;真菌21株,占11.41%。(2)革兰阴性菌组、革兰阳性菌组、真菌组三组间起病日龄和出生胎龄差异均有统计学意义(F值分别为18.120、6.046,P<0.05)。两两比较显示,革兰阳性菌组、革兰阴性菌组与真菌组出生胎龄比较,差异均有统计学意义(P<0.05),革兰阴性菌组、革兰阳性菌组中早发型与晚发型败血症患儿起病日龄差异有统计学意义(P<0.05)。(3)革兰阴性菌组、革兰阳性菌组、真菌组的血红蛋白、血小板计数、C反应蛋白(CRP)比较差异均有统计学意义(F/Z值分别为3.465、22.748、11.496,P<0.05)。两两比较显示,革兰阳性菌组的血红蛋白高于真菌组,差异有统计学意义(P<0.05);革兰阳性菌组与革兰阴性菌组血小板计数比较(Z=4.406),革兰阳性菌组与真菌组血小板计数比较(Z=3.725),差异均有统计学意义(P<0.05);革兰阴性菌组和真菌组CRP比较,差异有统计学意义(Z=3.273,P<0.05)。革兰阴性菌组、革兰阳性菌组中早发型与晚发型败血症患儿血红蛋白、血小板计数、CRP水平差异均有统计学意义(P<0.05)。(4)革兰阴性菌组、革兰阳性菌组、真菌组三组间细菌性脑膜炎、休克发生率差异均有统计学意义(χ^(2)值分别为9.382、81.662,P<0.05)。两两比较显示,在细菌性脑膜炎方面:革兰阳性菌组与革兰阴性菌组(Z=6.511),革兰阴性菌组与真菌组比较(Z=3.952),差异均有统计学意义(P<0.05);休克方面:革兰阳性菌组与革兰阴性菌组(Z=72.482),革兰阳性菌组Objective To investigate the clinical characteristics of septicemia in preterm infants caused by Gram-negative bacteria(G-),Gram-positive bacteria(G+)and fungal.Methods A retrospective analysis was performed on 184 preterm infants with septicemia in the Neonatal Intensive Care Unit(NICU)of Northwest Women and Children’s Hospital from January 1,2015 to December 31,2019.According to blood culture results,they were divided into G-group,G+group and fungal group,and the clinical characteristics of preterm infants with septicemia caused by different pathogens were compared.Results Among the blood culture-positive pathogens,there were 118 G-,accounting for 64.13%;45 G+,accounting for 24.45%;and 21 fungi,accounting for 11.41%.There were significant differences in the age of onset and gestational age at birth among the G-group,the G+group,and the fungus group(F=18.120and 6.046,respectively,P<0.05).Pairwise comparison showed that the gestational age at birth in the G+group,the G-group and the fungus group was significantly different(P<0.05).There was a statistically significant difference in the age of onset between the earlyonset and late-onset septicemia children in the G-group and the G+group(P<0.05).There were statistically significant differences in hemoglobin,platelet count and C-reactive protein(CRP)in the G-group and G+group,and the fungal group(F/Z=3.465,22.748,and 11.496,respectively,P<0.05).Pairwise comparison showed that the hemoglobin in the G+group was higher than that in the fungus group,and the difference was statistically significant(P<0.05).There was statistically significant difference in the platelet count between the G+group and the G-group(Z=4.406,P<0.05),and between the G+group and the fungus group(Z=3.725,P<0.05).There was a statistically significant difference in CRP between the G-group and the fungus group(Z=3.273,P<0.05).There were significant differences in the hemoglobin count,platelet count and CRP level between the early-onset and late-onset septicemia children in the G-group and the G+grou

关 键 词：新生儿 重症监护病房 早产儿 败血症 病原菌 临床特点 

分 类 号：R174[医药卫生—妇幼卫生保健]