本文關鍵詞： 新生兒 壞死性小腸結腸炎 敗血癥 病原菌　出處：《重慶醫(yī)科大學學報》2013年10期 　論文類型：期刊論文

【摘要】：目的:了解新生兒壞死性小腸結腸炎(neonatal necrotizing enterocolitis,NEC)并發(fā)敗血癥的發(fā)病率、相關高危因素及病原菌。方法:對2000年7月至2013年2月在我院確診的277例新生兒NEC患兒的臨床資料進行回顧性統(tǒng)計,對并發(fā)敗血癥群體和其血/腹腔液培養(yǎng)結果進行分析總結。結果:我院新生兒NEC并發(fā)敗血癥的發(fā)病率為28.5%(79/277)。79例患兒中,平均胎齡(36.62±3.26)周,早產兒32例(40.5%),早產兒的發(fā)生率更高(P=0.049);平均出生體質量(2 551.06±737.90)g;平均發(fā)病日齡(10.30±12.18)d,早產兒平均發(fā)病日齡(12.90±16.23)d,胎齡越小,發(fā)病時間越晚;母親圍產期因素以感染性疾病史、胎膜早破及羊水異常居多;臨床表現以腹脹、嘔吐、少吃少哭少動和高膽紅素血癥為主;其他主要合并或并發(fā)癥為肺炎、腸穿孔和腹膜炎;血液分析符合臨床診斷標準72例(91.1%);治愈19例(24.1%),好轉28例(35.4%),放棄23例(29.1%),死亡9例(11.4%)。臨床分期以Ⅲ期為主(49例,62.2%)。培養(yǎng)結果:72份標本共分離病原菌13種38株,血培養(yǎng)陽性率46.9%,腹腔液培養(yǎng)陽性率66.7%,主要有肺炎克雷伯菌(29.1%)和大腸埃希菌(29.1%)。結論:Ⅱ期以上NEC易并發(fā)敗血癥,病原菌以腸桿菌科為主。確診NEC時,應常規(guī)做血培養(yǎng),重視厭氧菌培養(yǎng),并定期監(jiān)測實驗室指標,注意監(jiān)控疾病發(fā)展,以便能切斷或減少腸源性敗血癥發(fā)生的機會。
[Abstract]:Objective: to investigate the incidence of septicemia in neonatal necrotizing enterocolitis (necrotizing). Methods: the clinical data of 277 neonates with NEC diagnosed in our hospital from July 2000 to February 2013 were analyzed retrospectively. Results: the incidence of neonatal NEC complicated with septicemia in our hospital was 28.579% 2770.79 cases. The average gestational age was 36.62 鹵3.26 weeks, 32 cases of premature infants were 40.5% and the incidence of preterm infants was higher than 0.049% of preterm infants. The average birth weight was 255.1.06 鹵737.90 g; The average onset age was 10.30 鹵12.18 days, and the average onset age of premature infants was 12.90 鹵16.23 days. The smaller the gestational age, the later the onset time. The maternal perinatal factors included infectious diseases, premature rupture of membranes and amniotic fluid abnormalities. The main clinical manifestations were abdominal distension, vomiting, less eating, less crying, less movement and hyperbilirubinemia. Other major complications or complications were pneumonia, intestinal perforation and peritonitis; The blood analysis was in accordance with the clinical diagnostic criteria in 72 cases. 19 cases were cured, 28 cases improved 35. 4%, 23 cases abandoned 29. 1%, 9 cases died 11. 4%. The clinical stage was mainly stage 鈪，

本文編號：1475726