新生儿败血症88例临床分析

目的 总结新生儿败血症的临床表现,并研究了其病原菌分布和临床抗生素耐药性状况,为治疗及降低新生儿败血症病死率提供依据.方法 分析对88例新生儿败血症的临床资料、实验室检查及药敏试验.结果 与结论新生儿败血症临床表现不典型,治疗采用综合疗法根据血培养药效结果选择抗生素.注意新生儿脐部皮肤护理及呼吸道感染减少该病发生率.     

新生儿机会菌败血症21例分析

新生儿由于免疫能力低下、现代复苏操作机会增多，以及广谱抗生素和糖皮质激素的广泛应用，罹患机会菌感染越来越多，已日益受到重视。我院近年收治新生儿败血症198例，其中机会菌败血症21例．占10．61％，分析如下。     

新生儿败血症致病菌分布及耐药性分析

目的 研究新生儿败血症感染致病菌分布及耐药性情况,为临床合理用药提供理论依据。方法 通过医院信息管理系统对我院2015年4月~2018年4月在围产儿科住院的共111例新生儿败血症的临床资料进行回顾性分析,对其所采血培养结果进行分析。结果 111例新生儿败血症患儿共检出菌株113株,其中革兰氏阳性菌103株（91.15%）,革兰氏阴性菌10株（8.85%）,真菌检出（0%）。革兰氏阳性菌以凝固酶阴性葡萄球菌（表皮葡萄球菌58株、溶血性葡萄球菌12株、人葡萄球菌9株、沃氏葡萄球菌3株）、粪肠球菌、金黄色葡萄球菌为主,分别为82株（72.57%）、10株（8.85%）、7株（6.19%）;革兰氏阴性菌以大肠埃希菌为主,共7株（6.19%）。革兰氏阳性球菌是新生儿败血症的主要病原菌,其对青霉素、红霉素及苯唑西林耐药率高,对万古霉素、替考拉宁100.00%敏感。革兰氏阴性菌对氨苄青霉素舒巴坦、氨苄西林、复方新诺明耐药率高,对亚胺培南、美洛培南敏感。结论 根据血培养药敏结果,选择敏感抗菌药物,合理使用抗生素,可减少细菌耐药的发生,提高临床治疗效果。     

新生儿败血症细菌耐药性与敏感性分析

目的　及早有效地干预治疗新生儿败血症 ,减少其死亡 .方法　分析了新生儿败血症的有关临床及致病菌的耐药性和敏感性资料 .结果　 32例新生儿败血症中死亡 5例 (15 .6 % ) ,医院感染 2例 (6 .2 5 % ) .严重的新生儿败血症有严重原发疾病 ,主要由革兰氏阴性菌引起 .主要的优势菌群有凝固酶阴性葡萄球菌、克雷伯菌、大肠埃希氏菌、铜绿假单胞菌 .结论　凝固酶阴性葡萄球菌是新生儿败血症最主要的病原菌 ,加强对复合菌或革兰氏阴性杆菌引起败血症的监测、治疗 ,严格执行各种治疗原则 ,预防医院感染败血症的发生 .     

新生儿败血症细菌耐药性与敏感性分析

目的及早有效地干预治疗新生儿败血症,减少其死亡.方法分析了新生儿败血症的有关临床及致病菌的耐药性和敏感性资料.结果 32例新生儿败血症中死亡5例(15.6%),医院感染2例(6.25%).严重的新生儿败血症有严重原发疾病,主要由革兰氏阴性菌引起.主要的优势菌群有凝固酶阴性葡萄球菌、克雷伯菌、大肠埃希氏菌、铜绿假单胞菌.结论凝固酶阴性葡萄球菌是新生儿败血症最主要的病原菌,加强对复合菌或革兰氏阴性杆菌引起败血症的监测、治疗,严格执行各种治疗原则,预防医院感染败血症的发生.     

新生儿败血症患者免疫功能观察

新生儿期易患各种感染性疾病,且易导致败血症,这与新生儿的免疫功能尚不成熟有关,我们检测了17例新生儿败血症患者治疗前后血清可溶性白介素2受体（sIL-2R)水平。膜结合的IL-2R（mIL-2R)表达及IgM、IgG水平的变化,以了解败血症患儿免疫功能的状况。     

多巴胺治疗新生儿败血症疗效观察

目的探讨多巴胺治疗新生儿败血症的疗效。方法将2006年后收治的符合新生儿败血症诊断标准[1]的新生儿15例在按常规吸氧、抗生素的基础上早期加用多巴胺。与2006年前符合新生儿败血症的新生儿20例进行对照。结果在积极抗感染的基础上早期加用多巴胺,患儿在3-5天内临床症状缓解,体温正常,生命体征稳定,停吸氧,进食及二便正常。结论早期应用多巴胺治疗新生儿败血症,可迅速改善新生儿症状、体征,减少并发症的发生,明显提高新生儿败血症的疗效。     

新生儿败血症临床病原学及药敏试验

目的探讨新生儿败血症病原体构成特点、影响因素及其抗菌谱.方法对185例经血培养证实的新生儿败血症病原学作回顾性分析.结果185例新生儿败血症的病原菌以葡萄球菌为最多,机会菌、大肠埃希菌次之,其他不太多见的还有链球菌、绿脓假单胞菌;其病原体构成与胎龄、生活方式、原发感染病灶密切相关;而其药物敏感试验示头孢唑啉、先锋必等为首选抗菌素.结论新生儿败血症病原学特点的分析,对指导临床诊治有重要价值.     

新生儿肠道机会杆菌败血症63例

本文对63例新生儿肠道机会杆菌败血症进行临床分析，结果表明：近年来，感染率明显增高，而免疫功能极低下的高危地表现更加明显，本组早产儿、足月小样儿、过期产儿占34．9％，一些患有严重疾病的患儿也易患此病；发病日龄4－14天，占63．5％，产后感染61．9％。另外，母乳喂养率下降也不容忽视，母乳不足、人工喂养占57．1％，临床表现缺乏特异，以青紫、苍白66．7％。反应差68．3％，黄疸46．0％等全身症状为主，合并症多，死亡率高达22．2％。提示：加强产后护理、提倡母乳喂养，对高危儿进行预防性治疗及合理用药是减少感染和死亡的有效措施。     

C反应蛋白诊断新生儿败血症准确性的Meta分析

目的 探讨CRP诊断新生儿败血症的诊断价值.方法 计算机检索维普中文科技期刊数据库、中国期刊全文数据库、万方数据库、中国生物医学文献数据库、Medline、EMBASE、Cochrane图书馆、PubMed等数据库（检索时间为1989年1月至2011年7月）,获得CRP诊断新生儿确诊败血症的文献.采用QUADAS工具对纳入文献进行质量评价.采用MetaDisc 1.4和RevMan 5.0软件检验各文献间的异质性,并根据异质性结果选择相应的效应模型进行加权定量合并,计算敏感度和特异度及其95%CI.绘制受试者工作特征（SROC）曲线并计算曲线下面积（AUC）,并行敏感度分析.结果 20篇文献进入Meta分析.分析结果显示：CRP诊断新生儿败血症的汇总敏感度和特异度分别为0.69（95%CI：0.65～0.72）和0.87（95%CI：0.86～0.89）,SROC AUC为0.88,Q＊指数为0.81.CRP＞8 mg·L-1诊断新生儿败血症的汇总敏感度和特异度分别为0.88（95%CI：0.82～0.92）和0.86 （95%CI：0.81～0.90）,SROC AUC为0.94,Q＊指数为0.88;CRP≥8 mg·L-1诊断新生儿败血症的汇总敏感度和特异度分别为0.54（95%CI：0.47～0.61）和0.81（95%CI：0.76～0.85）,SROC AUC为0.80,Q＊指数为0.74;两者合并诊断新生儿败血症的汇总敏感度和特异度分别为0.70（95%CI：0.65～0.74）和0.83（95%CI：0.80～0.86）,SROC AUC为0.88,Q＊指数为0.82.在纳入文献中标本来源和检测方法的差异等非阈值效应因素是产生异质性的原因.结论 CRP对新生儿败血症诊断的敏感度和特异度较高,有助于早期诊断新生儿败血症.     

新生儿血小板减少症46例临床分析

目的分析新生儿血小板减少的临床特点及可能原因,探讨其预防和治疗措施。方法回顾性分析本院2008年1月～2009年7月诊断新生儿血小板减少症所有患儿的临床资料。结果早发型血小板减少患儿临床上多无特殊表现,预后较好;迟发型血小板减少症多发生于早产儿,小于胎龄儿,通常由于合并严重感染所致,病情严重,需要输注血小板来治疗。结论围产期有高危因素母亲,其新生儿出生后要常规监测血常规,对于宫内发育不良或低出生体质量儿生后一旦合并感染要警惕血小板减少,甚至DIC的发生。     

16年新生儿感染性疾病513例分析

目的：了解１６年来本地区新生儿感染性疾病的发病情况。方法：用回顾性分析法对本院１６年来的住院新生儿感染性疾病进行逐一分析。结果：新生儿感染性疾病５１３例，占儿科住院总数的２．９％，占新生儿住院总数的６５．９％，发病率节夏季最高达１／３，春季最低为１／５。     

新生儿感染性疾病16年5 13例对照分析

目的：了解１６年来本地区新生儿感染性疾病的发病情况及病种变迁。方法：用回顾性分析法对本院１６年来（分先后８年Ａ、Ｂ线住院的新生儿感染性疾病逐一对照分析。结果１６年共５１３例,Ａ、Ｂ两组肺炎占本组感染性疾病的３６．１％与４５．２％,拟诊败血症为１９．２％与３．９％,确诊败血症为１．６％与７．９％（Ｐ〈０．０１）,脐炎１７．６％与２４．８％,支气管炎８．７％与３．９％,各种肠炎１０．９％与６．７％,口炎４．９％与２．５％,梅毒０与３．６％,化脓性脑膜炎０．５％与１．５％,皮炎０．５与０。两组治愈率为６６．１％和６０．３％,好转率１３．７％与２４．２％,恶化率５．５％与１０．７％,死亡率１４．７％与４．８％,Ｐ均〉０．０５。两组共死亡４３例,其中肺炎占首位,共１２例。结论：本地区新生儿各种疾病的发病率、住院率有所提高     

Clinical pathology in the neonatal rat

This study was performed to collate background data for a range of blood pathology parameters in neonatal rats, strain Crl: CD BR VAF/Plus, which could be used to assess organ maturity and function. This information was considered necessary as concern over neonatal toxicity has been expressed by scientists in the pharmaceutical, agrochemical and industrial fields.Haematological and clinical chemistry profiles were generated from neonate blood samples, taken via cardiac puncture. Samples were obtained, under terminal anaesthesia, on days 4, 12, 15 and 20 post partum. Analyses were performed on a regime of pooled and individual samples per sex for each litter. All results were compared with normal blood parameter ranges for non-pregnant rats aged approximately 9–10 weeks.The haematological profile indicated that the pups had an immature haemopoietic system and were developing subclinical but physiological anaemia in the early postnatal period. This was shown by low and decreasing Hb concentration and MCHC, a large proportion of reticulocytes in the red cell mass and low RBC, PCV, total and differential WBC. APTT was considerably shorter in the neonate, whereas PT was longer. Fibrinogen concentration was low.Principal findings from the clinical chemistry profile indicated apparent immaturity of the liver, kidneys and adrenal cortex. In the time course observed GPT, albumin, globulins, sodium and chloride increased; potassium, urea and bilirubin decreased; AP, calcium, phosphates, triglycerides and cholesterol levels were high compared with normal adult ranges.Both profiles showed there to be no obvious differences between the male and female pups up to 20 days post partum.     

Trends in epidemiology of neonatal sepsis in a tertiary center in Korea: a 26-year longitudinal analysis, 1980-2005

There were many reports of longitudinal changes in the causative organisms of neonatal sepsis in Western countries but few in Asia. We aimed to study longitudinal trends in the epidemiology of neonatal sepsis at Seoul National University Children's Hospital (SNUCH), a tertiary center in Korea, and compared the results to previous studies of Western countries. The medical records of all of the neonates who were hospitalized at SNUCH from 1996 to 2005 with positive blood cultures were reviewed. We also compared the findings to previous 16-yr (1980-1995). One hundred and forty-nine organisms were identified in 147 episodes from 134 infants. In comparison with the previous 16-yr studies, there was a decrease in the number of Escherichia coli infections (16.2% vs 8.7%: odds ratio [OR] 0.495; 95% confidence interval [CI], 0.255-0.962; P = 0.035), but an increase in Staphylococcus aureus (16.6% vs 25.5%: OR 1.720; 95% CI, 1.043-2.839; P = 0.033) and fungal infections (3.3% vs 18.7%: OR 6.740; 95% CI, 2.981-15.239; P < 0.001), predominantly caused by Candida species. In conclusion, the incidence of sepsis caused by E. coli decreases, but S. aureus and fungal sepsis increases significantly. Compared with Western studies, the incidence of sepsis caused by S. aureus and fungus has remarkably increased.     

Expression of S100 family proteins in neonatal rats with sepsis and its significance

Objective: This study aims to study the expression changes of S100 family proteins in neonatal rats with sepsis and investigate the effect and significance of S100 family proteins in pathogenesis and development of sepsis. Methods: The functions of S100 family proteins were analyzed with bioinformatics. The immune-associated proteins were chosen as the candidate proteins. Twenty neonatal SPF SD rats were randomly divided into two groups: sepsis model group and control group. The liver sample was stained with HE to evaluate the establishment of sepsis model. The expression amount of proinflammatory factor IL-1, IL-6 and TNF-α was detected with ELISA. The expression changes of S100A8, S100A9, S100A11 and S100A12 in sepsis model rats were detected with real-time PCR and Western blotting. After shRNA plasmid was transfected into THP-1 cells and the expression of S100A12 was silenced, the expression changes of proinflammatory factor IL-1, IL-6 and TNF-α in LPS-induced inflammation were studied in order to investigate the S100A12 mediated inflammatory process. Results: IL-1, IL-6 and TNF-α in the serum of rats with sepsis induced by LPS were 55.79 ± 3.80 ng/l, 48.76 ± 1.03 ng/l and 29.98 ± 2.27 ng/l respectively. S100A8, S100A9, S100A11 and S100A12 detected with real-time PCR in sepsis model group were 14.4 ± 1.37, 10.23 ± 1.81, 5.5 ± 1.64 and 9.97 ± 1.82 respectively. Compared with the control group, S100A8, S100A9, and S100A12 were significantly up-regulated. The shRNA silenced the expression of S100A12 which reduced the expression of proinflammatory factors after LPS stimulated the cells (P < 0.05). Conclusion: Compared with the control group, S100A8, S100A9, and S100A12 were significantly up-regulated in rat sepsis model group. After the expression of S100A12 in propylene glycol monomethyl ether acetate (PMA) induced human macrophages was silenced, the expression of proinflammatory factor IL-1, IL-6 and TNF-α was down-regulated.     

新生儿肠闭锁58例临床分析

目的总结分析新生儿肠闭锁及梗阻的早期诊断及治疗方法和对预后的影响.方法总结58例新生儿肠闭锁及狭窄,患儿的临床资料,分型,治疗及疗效进行回顾性分析.结果手术治疗58例,治愈52例,术后放弃治疗6例,术后并发症17例.结论早期诊断尤其是产前诊断提高肠闭锁的治愈率并可减少并发症,闭锁部位及类型,手术方式,围手术期管理,并发症是影响预后的主要因素.     

新生儿消化道畸形临床分析

目的:了解新生儿先天性消化道畸形的临床特点。方法:对74例新生儿消化道畸形进行回顾分析。结果:以肛门闭锁的发病率占首位,其次为巨结肠和肠闭锁。临床表现主要有呕吐(56％)、腹胀(68％)、胎便排出延迟及便秘(56％)、黄疸(33％)。合并其他畸形率为27％。男:女发病率3:1。结论:呕吐、腹胀、胎便排出延迟及便秘、黄疸为新生儿先天性消化道畸形的主要临床表现。     

新生儿心律失常56例临床分析

本文报道经临床表现和心电图确诊新生儿心律失常56例,其中房性早搏15例(26.7%),室性早搏12例(21.4%),室上性阵发性心动过速10例(17.8%),先天性房室传导阻滞6例(10.6%),窦性心动过缓6例(10. 6%),右束支阻滞6例(10.6%),新生儿心律失常类型以房性早搏最多:其次是室性早搏、室上性阵发性心动过速、房室传导阻滞.新生儿心律失常的病因以感染为主,本文感染29例(51.7%),其次心脏结构异常,先天性房室传导阻滞6例(10.6%),文中讨论了新生儿心律失常的治疗及其结果.