早产儿中枢神经系统感染病因分析及干预措施  

Etiological analysis and intervention measures of central nervous system infection in premature infants

作　　者：隗秋连 KUI Qiu-lian(Early Child Comprehensive Development Service Center,Beijing Fangshan District Maternal and Child Health Care Hospital,Beijing,102488,China)

机构地区：[1]北京市房山区妇幼保健院儿童早期综合发展服务中心,北京102488

出　　处：《中华养生保健》2023年第18期35-38,共4页CHINESE HEALTH CARE

摘　　要：目的调查分析早产儿中枢神经系统感染病因,并提出了相关干预措施。方法选取2019年6月—2022年5月在北京市房山区妇幼保健院住院的92例早产儿作为研究对象,判定中枢神经系统感染情况,调查所有早产儿的一般资料,并进行病因的多因素分析。所有中枢神经系统感染早产儿给予对症治疗干预,调查患儿预后情况。结果92例早产儿中,发生中枢神经系统感染12例(感染组),占比13.04%。感染病原体分别为李斯特菌1例、无乳链球菌2例、肺炎克雷伯菌7例、大肠埃希菌1例、人葡萄球菌1例。感染组早产儿的性别、胎龄、体重等与非感染组比较,差异无统计学意义(P>0.05);感染组早产儿的5 min Apgar评分、早产儿住院时间、早产儿窒息、母体妊娠期间感染、早产儿鼻吸氧等与非感染组比较,差异有统计学意义(P<0.05)。Spearman分析显示5 min Apgar评分、早产儿住院时间、早产儿窒息、母体妊娠期间感染、早产儿鼻吸氧与中枢神经系统感染存在相关性,差异有统计学意义(P<0.05)。Logistic回归分析显示5 min Apgar评分、早产儿住院时间、早产儿窒息、母体妊娠期间感染都为导致早产儿中枢神经系统感染的重要因素,差异有统计学意义(P<0.05)。经过对症治疗3个月后,12例患儿Gesell量表大运动、语言、个人-社交能力、精细动作、适应性行为等评分都显著高于治疗前,智力发育指数、运动发育指数与治疗前相比也显著提高,差异有统计学意义(P<0.05)。结论早产儿中枢神经系统感染在临床上比较常见,病原体多为肺炎克雷伯菌,5 min Apgar评分、早产儿住院时间、早产儿窒息、母体妊娠期间感染都是导致早产儿中枢神经系统感染的重要因素,加强早期治疗能显著改善患儿的综合发育状况。Objective To investigate and analyse the causes of central nervous system infection in premature infants and put forward relevant intervention measures.Methods 92 cases of premature infants hospitalized in Beijing Fangshan District Maternal and Child Health Care Hospital from June 2019 to May 2022 were selected as the study subjects.All the cases were examined to determine the infection of the central nervous system,and the general data of all premature infants were investigated.Multifactor analysis of the etiology was conducted.All premature infants with central nervous system infection were given symptomatic treatment intervention,and were to investigate the prognosis of the children.Results The central nervous system infection occurred in 12 cases of 92 premature infants(infection group),accounting for 13.0%.The infectious pathogens were Listeria monocytogenes in 1 case,Streptococcus lactis in 2 cases,Klebsiella pneumoniae in 7 cases,Escherichia coli in 1 case,and Staphylococcus aureus in 1 case.There were no signifi cant diff erences in sex,gestational age and weight compared between the infected group and the non-infected group(P>0.05).There were significant difference compared between the infected group and the non-infected group(P<0.05)in the 5-minute Apgar score,hospitalization stay of premature infants,asphyxia of premature infants,infection during maternal pregnancy,and nasal oxygen inhalation of premature infants.Spearman analysis showed that the 5 min Apgar score,hospitalization time of premature infants,asphyxia of premature infants,infection during maternal pregnancy,nasal oxygen inhalation of premature infants were correlated with central nervous system infection(P<0.05).Logistic regression analysis showed that 5 min Apgar score,hospitalization time of premature infants,asphyxia of premature infants and maternal infection during pregnancy were all important factors leaded to central nervous system infection of premature infants(P<0.05).After 3 months of symptomatic treatment,12 children's Gesell sc

关 键 词：早产儿 中枢神经系统感染 肺炎克雷伯菌 病因 Gesell量表评分 APGAR评分 

分 类 号：R741[医药卫生—神经病学与精神病学]