新生儿重症细菌性肺炎死亡相关危险因素分析

发布时间：2018-07-18 07:30

【摘要】：目的探讨新生儿重症细菌性肺炎的死亡危险因素。方法回顾分析2011年1月—2015年11月249例新生儿重症细菌性肺炎患儿的临床资料,分析死亡相关因素。结果 249例患儿中,死亡45例,病死率18.07%。细菌培养检出病原菌251株,前5位病原菌依次为大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌、肺炎链球菌及表皮葡萄球菌。单因素分析显示,死亡组与存活组的出生胎龄、胎膜早破、入院时日龄、出生体质量、喂养方式、Apgar评分、总胆红素值、并发症、创伤性治疗、肠外营养和多重耐药菌感染之间差异有统计学意义(P均0.05)。多因素logistic回归分析显示,入院时日龄7天(OR=4.30,95%CI:1.74~10.64)、Apgar评分7分(OR=3.24,95%CI:1.23~8.49)、有并发症(OR=6.81,95%CI:2.65~17.46)、多重耐药菌感染(OR=6.16,95%CI:1.90~19.99)及创伤性治疗(OR=3.82,95%CI:1.03~14.16)是新生儿重症细菌性肺炎患儿死亡的独立危险因素(P均0.05)。结论新生儿重症细菌性肺炎病死率较高,入院时日龄小、Apagar评分低、有并发症、多重耐药菌感染及创伤性治疗是死亡的主要危险因素。
[Abstract]:Objective to investigate the risk factors of death in neonatal severe bacterial pneumonia. Methods Clinical data of 249 neonates with severe bacterial pneumonia from January 2011 to November 2015 were analyzed retrospectively. Results of 249 children, 45 died and the mortality was 18.07. 251 strains of pathogenic bacteria were detected in bacterial culture. The first five pathogens were Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae and Staphylococcus epidermidis. Univariate analysis showed that birth age, premature rupture of membranes, age at admission, birth weight, feeding method Apgar score, total bilirubin value, complications, traumatic treatment, and so on. There was significant difference between parenteral nutrition and multidrug resistant bacteria infection (P 0.05). Multivariate logistic regression analysis showed that the age of 7 days on admission (OR4.3095 CI: 1.7410.64) and Apgar score (OR3.24995 CI: 1.238.49), complications (OR6.8195CI2.65c17.46), multidrug resistant bacteria infection (OR6.16995 CIW 1.90,19.99) and traumatic treatment (OR3.8295CIV1.0314.16) were independent risk factors for the death of neonates with severe bacterial pneumonia (all P 0.05). Conclusion the mortality rate of neonatal severe bacterial pneumonia is high, the Apagar score is low at admission, there are complications, multidrug resistant bacteria infection and traumatic treatment are the main risk factors of death.
【作者单位】：贵州医科大学第三附属医院;
【基金】：贵州省黔南州社会发展科技项目(No.黔南科合社字[2013]20号)
【分类号】：R722.135

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