324例早产儿败血症临床分析

目的探讨早产儿败血症患者的临床特征，为其早期诊断、治疗提供指导依据和协助判断预后。方法对2012年6月至2014年6月本院新生儿病房确诊的早产儿败血症324例临床资料进行回顾性分析。结果早产儿败血症以晚发型败血症（≥7 d）和院内感染败血症为主；临床表现无特异性，并发症以肺炎、弥散性血管内凝血、化脓性脑膜炎为主；血小板和高敏 C反应蛋白（hs-CRP）异常发生率高；病原菌以革兰阴性菌为主，其次为革兰阳性菌和真菌；药敏显示革兰阴性菌对喹诺酮类抗生素、氨基糖苷类抗生素和碳青酶烯类抗生素较敏感；死亡16例，以出生胎龄＜ 32周、出生体质量＜ 1500 g 者病死率高；5例诊断神经发育损害。结论早产儿败血症早期症状不典型，院感和合并症发生率高，监测血小板和 hs-CRP 有助于早产儿败血症的早期诊治。

Clinical Analysis of 324 Premature Infants with Sepsis

Obj ective]To analyze the clinical features and prognosis of sepsis in premature infant so as to provide the basis for guiding early diagnosis and treatment and help to assess the prognosis.Methods]Clini-cal data of 324 premature infants with sepsis in neonatal ward of our hospital from June 2012 to June 2014 were analyzed retrospectively.Results]The late-onset sepsis（≥7 days）and nosocomial infection were commonly seen in premature infants with sepsis.Clinical manifestations were not specific.The main complications were pneumonia,disseminated intravascular coagulation and purulent meningitis.The abnormal rate of blood plate-let and high sensitivity C-reactive protein was higher.Gram-negative bacteria were the main pathogens,and gram-positive bacteria and fungi were the second.Drug sensitivity test showed that gram-negative bacteria were more sensitive to quinolones,aminoglycosides and carbopenems.Sixteen infants died.During the follow up of some patients,5 patients were diagnosed as neurodevelopmental impairment（NDI）.Conclusion]Early symptoms of premature infant with sepsis are atypical.The incidence rates of nosocomial infection and compli-cations are high.Monitoring blood platelet and high sensitivity C-reactive protein is helpful for early diagnosis and treatment of sepsis in premature infant.