极低/超低出生体质量儿晚发型败血症死亡相关因素分析

目的 探讨极低/超低出生体质量儿并发晚发型败血症死亡的高危因素.方法 选取2016年9月—2019年12月收治的血培养确诊晚发型败血症的极低/超低出生体质量儿,分析临床资料,找出死亡相关及独立危险因素.结果 538例极低/超低出生体质量儿发生晚发型败血症66例,发病率12.27％,死亡15例,病死率22.73％.胎龄小...

Risk Factors for Death of Late Onset Sepsis in Very/extremely Low Birth Weight Infant

Objective To investigate the risk factors for death of Lateonset Sepsis(LOS)in very/extremely low birth weight infant(V/ELBWI).Methods Clinical and laboratory data of culture proven LOS cases admitted to our hospital from September 2016 to December 2019 were collected and analyzed retrospectively.Results 66 cases in 538 V/ELBWIs enrolled had LOS.The incidence was 12.27%and mortality was 22.73%.Univariate analysis showed risk factors associated with death of LOS in V/ELBWI:low gestational age and birth weight,longer duration of umbilical artery catheterization(UAC)and antibiotic therapy,peripherally inserted central catheter(PICC),mechanical ventilation,more than 3 species of antibiotics applied before onset of LOS,thrombocytopenia,elevated hs CRP,shorter time to positivity of blood cultures and gram-negative bacterial infection(P<0.05).The death group had significantly higher morbidity of shock,necrotizing Enterocolitis(NEC)and disseminated intravascular coagulation(DIC)(P<0.05).The multivariate logistic regression analysis showed that low gestational age,shock,NEC and thrombocytopenia within 24~72 h were independent risk factors.Conclusion Low gestational age,more severe complications,especially septic shock and NEC,persistent thrombocytopenia were independent risk factors for death of LOS in V/ELBWI.