新生儿急性骨髓炎临床特点及预后

目的探讨新生儿急性骨髓炎的临床特点、诊断及早期治疗。方法选择2009—2012年我院NICU收治的急性骨髓炎患儿，回顾性分析其临床特点、诊疗经过及预后情况。结果研究期间共收治8例新生儿急性骨髓炎患儿。发热、肢体活动受限、触摸或被动活动患肢时哭闹明显、患处软组织肿胀等是新生儿急性骨髓炎急性期典型临床表现。5例患儿痊愈，随访10～30个月，均无后遗症发生；穿刺有脓性液体的2例患儿转骨外科行引流、牵引、抗感染等治疗，随访患肢活动存在异常；1例患儿入院不足2天因发生多器官功能衰竭死亡。结论新生儿期急性骨髓炎早期缺乏特异性表现，早期诊断和足疗程治疗可减少后遗症发生。

Clinical features and prognosis of neonates with neonatal acute osteomyelitis

Objective To discuss clinical features, diagnosis and early management of acute osteomyelitis in neonates. Methods The eight neonates participated in this retrospective study were identified from NICU admissions of 2009 -2012. Their clinical features, diagnostic work up and prognosis were analyzed. Results Fever, limited limb activities, crying with touch or passive movement of extremities, soft tissue swelling of the affected area were typical clinical manifestations in the acute phase of osteomyelitis in neonates. Five infants were fully recovered from acute osteomyelitis without sequelae at the 10 -30 months follow up visits. Two infants with purulent fluid identified from needle puncture of the wound were transferred to Orthopedic surgeons and received incision ＆ drainage, traction, antibiotic treatments. Follow up visit at 10-30 months found abnormal movements of the sick limb. One patient died within two days due to multiple organ failure. Conclusions Neonates with early phase of neonatal acute osteomyelitis present with non-specific clinical symptoms. Early diagnosis and a full course of treatment may decrease the occurrence of morbidity in future.