【摘要】：目的分析我院新生兒膿毒癥臨床資料，探討其臨床特點，提高對新生兒膿毒癥的認識。 方法選取2011年1月至2013年12月期間廣西醫(yī)科大學第一附屬醫(yī)院收治的213例新生兒膿毒癥患兒，回顧性分析其一般情況、臨床表現(xiàn)、主要診斷、實驗室檢查、轉(zhuǎn)歸等情況。 結(jié)果我院3年間共發(fā)生213例次新生兒膿毒癥，其中早發(fā)型膿毒癥126例（59.2%），平均胎齡37周；晚發(fā)型膿毒癥87例（40.8%），平均胎齡35周，兩組胎齡P＜0.05。合并癥中較常見的依次是肺炎（53.1%）、貧血（48.4%）、電解質(zhì)紊亂（36.6%）。早發(fā)型較晚發(fā)型更易發(fā)生消化道出血，而晚發(fā)型較易發(fā)生顱內(nèi)感染，P＜0.05。調(diào)查中有98例病原學陽性標本，痰培養(yǎng)陽性40例，血培養(yǎng)陽性35例。革蘭氏陰性菌居多，約占56.1%，革蘭氏陽性菌株占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%），早發(fā)型預后較晚發(fā)性差（P＜0.05）。 結(jié)論我院新生兒膿毒癥患兒以低出生體重及早產(chǎn)兒居多。臨床表現(xiàn)中體溫異常最為常見，其次是黃疸、反應差。早發(fā)型發(fā)病日齡集中在1-3天，預后差，，死亡率高。晚發(fā)多于8-10天發(fā)病，預后較好，死亡率低。我院感染以革蘭氏陰性菌為主,但真菌及條件致病菌也在增加。
[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.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R720.597

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