新生儿寒冷损伤与全身炎症反应综合征关系的临床研究

目的　探讨新生儿寒冷损伤与全身炎症反应综合征 (SIRS)发生的关系。方法　对 6 0例以寒冷损伤综合征为原发病并排除合并感染的新生儿 ,根据SIRS的发生与否分SIRS组及非SIRS组 ,比较两组入院时体温、复温时间 (低温持续时间 ) ,复温速度及其多器官功能障碍综合征 (MODS)发生率、病死率 ;并比较不同体温患儿SIRS和MODS发生率、病死率 ;比较SIRS组中符合SIRS项目数与存活率的关系 ;以及两组发生MODS的具体脏器分布的差异。结果　SIRS组复温时间较非SIRS组长 (P <0 0 5 ) ,复温速度比非SIRS组慢 (P <0 0 5 ) ,MODS发生率SIRS组比非SIRS组明显升高 (P <0 0 5 ) ,病死率比较无显著性差异。不同体温组中SIRS及MODS发生率、病死率比较差异具有显著性意义 ,体温越低 ,SIRS及MODS发生率、病死率越高。发生 3个以上器官损害患儿的病死率较 2个器官损害患儿的病死率高。结论　在新生儿寒冷损伤综合征中 ,SIRS及MODS的发生、发展与低体温严重程度及持续时间密切相关。

Clinical relationship between neonatal cold injury and systemic inflammatory response syndrome

Objective To study the clinical relationship between neonatal cold injury and systemic inflammatory response syndrome(SIRS).Methods 60 infants with primary cold injury but without infectious diseases,were divided into SIRS group and non-SIRS group.The initiative temperature,re-warming time (the duration of hypothermia ),re-warming rate,the incidence of multiple organ dysfunction syndrome (MODS) and mortality rate in two groups were compared,as well as the incidence of SIRS and MODS,mortality rate in infants with different temperature.The relationship between number of index confirmed to SIRS diagnostic and survival rate in SIRS group was analyzed,as well as the difference of distribution of organ dysfunction.Results The re-warming time in SIRS group was significantly longer than that in non-SIRS group(P<0.05);the re-warming rate was significantly slower and the incidence rate of MODS was significantly higher in SIRS group than that in non-SIRS group.The mortality rate was not significantly different between two groups.The incidence rate of SIRS and MODS and the mortality were significantly different between groups of different temperatures.The lower the temperature,the higher the incidence rate and the mortality rate.The mortality rate in patients with more than three organs of dysfunction was significantly higher than in those with two organs(P<0.05).Conclusion In neonatal cold injury syndrome,the onset and development of SIRS and MODS are closely related to the degree and duration of hypothermia.