早产儿医院感染临床特征及危险因素分析  

Analysis of clinical features and risk factors of nosocomial infection in premature infants

作　　者：陈建生[1] CHEN Jiansheng(Department of Neonatology,Puning Maternal and Child Health Hos pital,Guangdong Province,Puning 515300,China)

机构地区：[1]广东省普宁市妇幼保健院新生儿科,广东普宁515300

出　　处：《妇儿健康导刊》2024年第24期64-67,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的分析早产儿医院感染临床特征及危险因素。方法收集2013年1月至2023年12月普宁市妇幼保健院新生儿科收治的2366例早产儿的临床资料,总结早产儿医院感染的临床特征,并进行危险因素分析。结果纳入的2366例早产儿中,发生医院感染73例(3.09%);胎龄、住院时间、出生体重、侵入性操作、抗生素使用时间、肠外营养支持、喂养不耐受(FI)与早产儿医院感染有关(P<0.05);性别、分娩方式、胎膜早破、胎盘早剥、前置胎盘、羊水污染、双胎与早产儿医院感染无关(P>0.05)。多因素分析显示,胎龄28~32周(β=1.749,OR=5.747,95%CI=3.577~9.235)、住院时间>2周(β=2.129,OR=8.408,95%CI=5.104~13.851)、出生体重<1500 g(β=1.804,OR=6.072,95%CI=3.777~9.763)、有侵入性操作(β=2.221,OR=9.214,95%CI=5.705~14.884)、抗生素使用时间>7 d(β=0.876,OR=2.402,95%CI=1.505~3.835)、肠外营养支持>7 d(β=2.094,OR=8.120,95%CI=4.431~14.879)、FI(β=1.062,OR=2.891,95%CI=1.809~4.621)是早产儿发生医院感染的危险因素(P<0.05)。结论胎龄小、住院时间长、出生体重低、接受侵入性操作、抗生素使用时间长、肠外营养支持时间长、FI的早产儿易发生医院感染,临床应针对上述因素制订相应的干预措施,以减少早产儿医院感染的发生。Objective To analyze the clinical features and risk factors of nosocomial infection in premature infants.Methods Clinical data of 2366 premature infants admitted to Department of Neonatology,Puning Maternal and Child Health Hospital from January 2013 to December 2023 were collected.Clinical characteristics of nosocomial infection in premature infants were summarized,and risk factors were analyzed.Results Among 2366 premature infants,73(3.09%)had nosocomial infection.Gestational age,length of hospital s tay,birth weight,invasive procedure,duration of antibiotic use,parenteral nutrition support,and feeding intolerance(FI)were associated with nosocomial infection in premature infants(P<0.05).Gender,mode of delivery,premature rupture of membranes,placental abruption,placenta previa,amniotic fluid contamination,and twins were not associated with nosocomial infection in preterm infants(P>0.05).Multivariate analysis showed that gestational age 28-32 weeks(β=1.749,OR=5.747,95%CI=3.577-9.235),length of hospital stay>2 weeks(β=2.129,OR=8.408,95%CI=5.104-13.851),birth weight<1500 g(β=1.804,OR=6.072,95%CI=3.777-9.763),invasive procedures(β=2.221,OR=9.214,95%CI=5.705-14.884),duration of antibiotic use>7 days(β=0.876,OR=2.402,95%CI=1.505-3.835),parenteral nutrition support>7 days(β=2.094,OR=8.120,95%CI=4.431-14.879),and FI(β=1.062,OR=2.891,95%CI=1.809-4.621)were high risk factors for nosocomial infection in preterm infants(P<0.05).Conclusion Premature infants with small gestational age,long hospital stay,low birth weight,invasive procedures,long antibiotic use time are prone to nosocomial infections.Clinical intervention measures should be formulated according to the above factors to reduce the occurrence of nosocomial infections in premature infants.

关 键 词：早产儿 喂养不耐受 医院感染 肠外营养支持 

分 类 号：R722.6[医药卫生—儿科]