新生儿败血症的临床特征及高危因素分析
Clinical characteristics and high-risk factors analysis of neonatal septicemia
姚艳青 1李雪1
作者信息
- 1. 首都医科大学附属北京友谊医院儿科 北京 100050
- 折叠
摘要
目的 分析新生儿败血症(NS)的临床特征及其发生的高危因素,为早期发现NS提供依据.方法 回顾性分析2018年3月至2023年2月在首都医科大学附属北京友谊医院新生儿病房因NS住院患儿的临床资料.发病时间≤3 d为早发型败血症(EOS),发病时间＞3 d为晚发型败血症(LOS).按发病年龄分为EOS组(n=71)和LOS组(n=40).分析两组患儿的一般资料、临床表现、孕母围产期资料、出现败血症高危因素情况、并发症及预后等资料.结果 EOS组患儿与LOS组患儿在出生体重分布方面,差异有统计学意义(P＜0.05).LOS组患儿平均胎龄及平均体重分别为(36.95±3.80)周、(2 750.23±959.81)g,均明显低于 EOS 组[(37.81±2.91)周、(2 950.63±737.92)g],差异均有统计学意义(P＜0.05).NS常见首发临床表现包括黄疸、体温异常、呼吸异常及反应差、纳差,其中LOS组患儿较EOS组患儿更容易以体温异常(42.50％vs.19.72％)及皮疹(7.50％vs.0)为首发临床表现,差异均有统计学意义(P＜0.05).LOS组多胎比例为22.50％,高于EOS组(5.63％),胎膜早破及宫内感染比例分别为15.00％、7.50％,均低于EOS组(45.07％、28.17％),差异均有统计学意义(P＜0.05).两组患儿的并发症及预后情况比较,差异均无统计学意义(P＞0.05).结论 NS首发临床表现多样.重视NS的高危因素,对于高危新生儿尽早进行血培养、脐血培养、感染指标检测,可以提高诊断的阳性率,改善患儿的预后.
Abstract
Objective To analyze the clinical characteristics and high-risk factors of neonatal septicemia(NS),and provide a basis for early identification of NS.Methods A retrospective analysis was conducted on the clinical data of hospitalized children with NS in the neonatal ward of Beijing Friendship Hospital,Capital Medical University from March 2018 to February 2023.The onset time≤3 d was early-onset sepsis(EOS),and the onset time＞3 d was late-onset sepsis(LOS).According to the age of onset,they were divided into EOS group(n=71)and LOS group(n=40).The general data,clinical manifestations,maternal perinatal data,the risk factors of sepsis,complications and outcomes of the two groups of children were analyzed.Results There was significant difference in birth weight distribution between EOS group and LOS group(P＜0.05).The average gestational age and average weight of LOS group were(36.95±3.80)weeks and(2 750.23±959.81)g,respective-ly,which were significantly lower than those of EOS group[(37.81±2.91)weeks and(2 950.63±737.92)g],the differences were statisti-cally significant(P＜0.05).The common initial clinical manifestations of NS include jaundice,abnormal body temperature,respiratory abnor-malities,poor response,and poor appetite.Among them,children in the LOS group were more likely to have abnormal body temperature(42.50％vs.19.72％)and rash(7.50％vs.0)as the initial clinical manifestations than those in the EOS group,and the differences were statistically sig-nificant(P＜0.05).The proportion of multiple births in LOS group was 22.50％,which was higher than that in EOS group(5.63％),the pro-portions of premature rupture of membranes and intrauterine infection were 15.00％and 7.50％,respectively,which were lower than those in EOS group(45.07％,28.17％),and the differences were statistically significant(P＜0.05).There were no significant differences in compli-cations and prognosis between the two groups(P＞0.05).Conclusion The initial clinical manifestations of NS are various.Pay attention to the high-risk factors of NS and conducting blood culture,cord blood culture,and infection index testing as early as possible for high-risk newborns can improve the positive rate of diagnosis and improve the prognosis of the affected children.
关键词
新生儿败血症/临床特征/高危因素/早发型败血症/晚发型败血症Key words
Neonatal septicemia/Clinical characteristics/High-risk factors/Early-onset septicemia/Late-onset septicemia引用本文复制引用
出版年
2024
NETL
NSTL
万方数据