中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
12期
1336-1339
,共4页
新生儿%败血症%血培养
新生兒%敗血癥%血培養
신생인%패혈증%혈배양
Neonatal%Sepsis%Blood culture
目的 分析比较新生儿早发型与晚发型败血症的感染途径、高危因素、临床特点及病原菌分布情况,指导临床早期诊断、治疗与干预.方法 根据发病时间对我院2006年1月至2011年12月收治的88例新生儿败血症患儿进行分组,分为早发型组与晚发型组,并进行对照分析.结果 在感染途径方面,两组患儿均以呼吸道感染多见(44.7％与46.0％),两组比较差异无统计学意义(P =0.906).两组间出生情况相比较,早产、出生体质量低、羊水污染、窒息均是新生儿败血症早期发病的高危因素.两组患儿临床特点相比较,早期发病者多以吃奶差(57.9％,22/38)入院,而晚期发病者易出现发热(42.0％,21/50).血培养阳性41例,阳性率46.6％(41/88),两组血培养阳性标本中均以革兰阳性菌为主,分别是75.0％(15/20)、90.4％(19/21),而金黄色葡萄球菌及凝固酶阴性葡萄球菌是主要致病菌.结论 早产、出生体质量低、羊水污染、窒息均是新生儿败血症早期发病的高危因素.早发型败血症常常表现为吃奶差,而晚发型败血症患儿易出现发热.早发型及晚发型败血症的常见致病菌均为革兰阳性菌,以金黄色葡萄球菌及凝固酶阴性葡萄球菌多见.针对有高危因素的患儿,应结合其临床特点早期行病原学检查,进一步明确诊断,指导临床合理用药.
目的 分析比較新生兒早髮型與晚髮型敗血癥的感染途徑、高危因素、臨床特點及病原菌分佈情況,指導臨床早期診斷、治療與榦預.方法 根據髮病時間對我院2006年1月至2011年12月收治的88例新生兒敗血癥患兒進行分組,分為早髮型組與晚髮型組,併進行對照分析.結果 在感染途徑方麵,兩組患兒均以呼吸道感染多見(44.7％與46.0％),兩組比較差異無統計學意義(P =0.906).兩組間齣生情況相比較,早產、齣生體質量低、羊水汙染、窒息均是新生兒敗血癥早期髮病的高危因素.兩組患兒臨床特點相比較,早期髮病者多以喫奶差(57.9％,22/38)入院,而晚期髮病者易齣現髮熱(42.0％,21/50).血培養暘性41例,暘性率46.6％(41/88),兩組血培養暘性標本中均以革蘭暘性菌為主,分彆是75.0％(15/20)、90.4％(19/21),而金黃色葡萄毬菌及凝固酶陰性葡萄毬菌是主要緻病菌.結論 早產、齣生體質量低、羊水汙染、窒息均是新生兒敗血癥早期髮病的高危因素.早髮型敗血癥常常錶現為喫奶差,而晚髮型敗血癥患兒易齣現髮熱.早髮型及晚髮型敗血癥的常見緻病菌均為革蘭暘性菌,以金黃色葡萄毬菌及凝固酶陰性葡萄毬菌多見.針對有高危因素的患兒,應結閤其臨床特點早期行病原學檢查,進一步明確診斷,指導臨床閤理用藥.
목적 분석비교신생인조발형여만발형패혈증적감염도경、고위인소、림상특점급병원균분포정황,지도림상조기진단、치료여간예.방법 근거발병시간대아원2006년1월지2011년12월수치적88례신생인패혈증환인진행분조,분위조발형조여만발형조,병진행대조분석.결과 재감염도경방면,량조환인균이호흡도감염다견(44.7％여46.0％),량조비교차이무통계학의의(P =0.906).량조간출생정황상비교,조산、출생체질량저、양수오염、질식균시신생인패혈증조기발병적고위인소.량조환인림상특점상비교,조기발병자다이흘내차(57.9％,22/38)입원,이만기발병자역출현발열(42.0％,21/50).혈배양양성41례,양성솔46.6％(41/88),량조혈배양양성표본중균이혁란양성균위주,분별시75.0％(15/20)、90.4％(19/21),이금황색포도구균급응고매음성포도구균시주요치병균.결론 조산、출생체질량저、양수오염、질식균시신생인패혈증조기발병적고위인소.조발형패혈증상상표현위흘내차,이만발형패혈증환인역출현발열.조발형급만발형패혈증적상견치병균균위혁란양성균,이금황색포도구균급응고매음성포도구균다견.침대유고위인소적환인,응결합기림상특점조기행병원학검사,진일보명학진단,지도림상합리용약.
Objective To analyse the pathway of infection,risk factors,clinical characteristics and pathogenic bacteria distribution of neonatal sepsis.Methods Eighty-eight neonatal with sepsis were enrooled from January 2006 to December 2011 in the First Affiliated Hospital of Lanzhou University.According to disease stage,they were divided into early-onset sepsis group and late-onset sepsis groups.Results Respiratory infections in two groups was the majority (44.7％ vs.46.0％),and there was no significant difference (P =0.906).That premature birth,low birth weight infant,amniotic fluid pollution and asphyxia were risk factors for early-onset sepsis.The most common clinical characteristics in early-onset sepsis were eating less milk(57.9％,22/38) and had fever of the late-onset sepsis(42.0％,21/50).Forty-one cases were with positive blood culture and the rate was 46.6％ (41/88),the blood culture specimens were mainly Gram-positive bacteria in two group (75.0％ (15/20),90.4％ (19/21)).The most common pathogenic bacteria were Staphylococcus aureus and Coagulase-negative staphylococci.Conclusion Premature birth,low birth weight,meconium,asphyxia are risk factors of early onset neonatal sepsis.Early-onset sepsis often shows poor feeding,and late-onset sepsis in children prone to be fever.The common pathogenic germ of early-onset and late-onset sepsis are Grampositivebacteria,Staphylococcus aureus and coagulase-negative staphylococci common.As for neonate with highrisk factors,clinical features of early pathologic examination should be performed in order to further clarify the diagnosis and taking clinical therapy.
