新生儿败血症早产儿与足月儿的临床特点分析

目的 探讨早产儿与足月儿新生儿败血症的临床特点,为临床诊治提供依据。方法 回顾性分析97例早产儿与43例足月儿败血症的临床资料。结果 早产儿晚发型败血症的比例高于足月儿(P<0.01),足月儿早发型败血症的比例高于早产儿(P<0.01)。胎膜早破、剖宫产、PICC置管、脐静脉置管和静脉营养在早产儿败血症中的比例高于足月儿(P均<0.01)。母亲围生期感染、羊水污染、顺产在足月儿败血症中的比例高于早产儿(P均<0.01)。早产儿败血症易表现为反应差、喂养不耐受、腹胀、呼吸暂停、呼吸困难、需机械通气治疗(P均<0.05或<0.01),易合并感染性休克和坏死性小肠结肠炎(P<0.01或<0.05),检测白细胞总数和血小板明显降低(P均< 0.01)。结论 早产儿与足月儿败血症在临床表现和实验室检查方面存在一定差异,早产儿败血症常累及多个系统的变化,应引起重视。

Analysis of clinical characteristics in preterm and term infants with sepsis.

Objective To evaluate the clinical characteristics of neonatal sepsis in preterm and term infants. Methods A total of 97 preterm and 43 term neonatal sepsis were retrospectively analyzed. Results Early-onset sepsis was higher in preterm neonatal sepsis than that in term neonatal sepsis (P<0.01).Conversely,late-onset sepsis was higher in term neonatal sepsis than that in preterm neonatal sepsis (P<0.01).Comparing with term neonatal sepsis,preterm neonatal sepsis tended more to accompany premature rupture of membranes,caesarean section,PICC catheterization,umbilical vein catheterization and intravenous nutrition (all P<0.01).Possibilities of mother perinatal infection,meconium-stained amniotic fluid and natural labor in term neonatal sepsis were higher than those in preterm neonatal sepsis (all P<0.01).Preterm neonatal sepsis tended to have low response,feeding intolerance,abdominal distension,apnea,dyspnea and ventilation treatment (all P<0.05 or <0.01).Term neonatal sepsis tended to have abnormal temperature,pathologic jaundice and skin infection (all P<0.01).Preterm neonatal sepsis was susceptible to complicate with infectious shock and neonatal necrotizing enterocolitis (P<0.01,<0.05).Their white blood cells and platelet obviously decreased (all P<0.01). Conclusions Sepsis in preterm and term infants is somewhat different in clinical manifestations and laboratory tests.Preterm neonatal sepsis often involves multiple systemic changes.