213例新生儿脓毒症临床特点分析

发布时间：2018-08-30 20:52

【摘要】：目的分析我院新生儿脓毒症临床资料，探讨其临床特点，提高对新生儿脓毒症的认识。方法选取2011年1月至2013年12月期间广西医科大学第一附属医院收治的213例新生儿脓毒症患儿，回顾性分析其一般情况、临床表现、主要诊断、实验室检查、转归等情况。结果我院3年间共发生213例次新生儿脓毒症，其中早发型脓毒症126例（59.2%），平均胎龄37周；晚发型脓毒症87例（40.8%），平均胎龄35周，两组胎龄P＜0.05。合并症中较常见的依次是肺炎（53.1%）、贫血（48.4%）、电解质紊乱（36.6%）。早发型较晚发型更易发生消化道出血，而晚发型较易发生颅内感染，P＜0.05。调查中有98例病原学阳性标本，痰培养阳性40例，血培养阳性35例。革兰氏阴性菌居多，约占56.1%，革兰氏阳性菌株占38.8%，真菌占5.1%。痊愈121例（56.8%），未愈78例（36.6%），死亡14人（6.6%），早发型预后较晚发性差（P＜0.05）。结论我院新生儿脓毒症患儿以低出生体重及早产儿居多。临床表现中体温异常最为常见，其次是黄疸、反应差。早发型发病日龄集中在1-3天，预后差，，死亡率高。晚发多于8-10天发病，预后较好，死亡率低。我院感染以革兰氏阴性菌为主,但真菌及条件致病菌也在增加。
[Abstract]:Objective to analyze the clinical data of neonatal sepsis in our hospital, to explore its clinical characteristics and to improve the understanding of neonatal sepsis. Methods 213 neonates with sepsis admitted in the first affiliated Hospital of Guangxi Medical University from January 2011 to December 2013 were analyzed retrospectively. The general situation, clinical manifestation, main diagnosis, laboratory examination and prognosis were analyzed retrospectively. Results 213 cases of neonatal sepsis occurred in our hospital during the past three years, among which 126 cases (59.2%) were early type sepsis (mean gestational age 37 weeks), 87 cases (40.8%) were late type sepsis, the mean gestational age was 35 weeks (P < 0.05). The most common complications were pneumonia (53.1%), anemia (48.4%) and electrolyte disorder (36.6%). The early type was more prone to gastrointestinal bleeding than the late type, while the late type was more prone to intracranial infection (P < 0.05). There were 98 pathogenic positive specimens, 40 sputum culture positive and 35 blood culture positive. Gram-negative bacteria accounted for 56.1%, Gram-positive strains 38.8% and fungi 5.1%. 121 cases (56.8%) were cured, 78 cases (36.6%) were uncured, 14 cases (6.6%) died. The prognosis of early onset was worse than that of late onset (P < 0.05). Conclusion low birth weight and premature infants are the majority of neonates with sepsis in our hospital. Abnormal body temperature is the most common clinical manifestation, followed by jaundice, poor response. The age of early onset was 1-3 days, with poor prognosis and high mortality. Late onset more than 8-10 days, the prognosis is better, the death rate is low. Gram-negative bacteria were the main infection in our hospital, but fungi and conditioned pathogens were also increasing.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R720.597

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