发热新生儿脑脊液异常的相关因素分析

【目的】探讨发热新生儿脑脊液异常的独立危险因素。【方法】根据脑脊液检查结果将325例发热新生儿分为观察组与对照组，观察组79例，脑脊液检查结果提示异常，对照组246例，脑脊液检查结果提示无异常。收集两组新生儿的临床资料指标，对新生儿脑脊液异常的相关影响因素采用 Logistic 回归分析法进行分析。【结果】①单因素分析显示：两组患儿羊水浑浊、分娩方式、性别、Apgar 评分、基础疾病、神经系统症状、尿常规结果、大便常规结果、血培养结果相比差异无统计学意义（ P ＞0．05），两组患儿胎膜早破、出生时体重、发热时日龄、最高体温、发热持续时间、感染类型相比差异有统计学意义（ P ＜0．05）。② Logistic 回归分析显示：胎膜早破、发热时日龄≤14 d 、最高体温≥38．5℃、发热持续时间≥3 d 、细菌感染是新生儿脑脊液异常的独立危险因素（ P ＜0．05），出生时体质量≤2．5 kg 是新生儿脑脊液异常的非独立危险因素（ P ＞0．05）。【结论】发热新生儿，当其母亲妊娠期出现胎膜早破，或者发热时日龄≤14 d ，或者最高体温≥38．5℃，或者发热持续时间≥3 d ，或者诊断为细菌感染时，临床应尽早进行脑脊液检查，以对新生儿颅内感染进行早期诊断、早期治疗。

Logistic Regression Analysis of the Independent Risk Factors of Abnormal Neonatal Cerebrospi-nal Fluid in Febrile Infants

Objective]To investigate the independent risk factors of neonatal cerebrospinal fluid abnormal‐ities in febrile infants .Methods] According to the result of cerebrospinal fluid examination ,325 febrile in‐fants were divided into an observation group of infants with abnormal indexes ( n = 79) and a control group of patients with normal indexes ( n = 246) .The clinical data of neonatal indicators of patients in the two groups were collected and analyzed using Logistic regression analysis .Results] (1) Single factor analysis showed that amniotic fluid turbidity ,method of childbirth ,sex ,Apgar(Appearance ,Pluse ,Grimace ,Activity ,Respiration) score ,basic diseases ,nervous system symptoms ,the result of urine routine ,stool routine ,and blood culture showed no statistically significance difference between the two groups ( P > 0 .05) .However ,the difference between the two groups of children in premature rupture of membranes ,birth weight ,highest temperature , time of fever occurring ,duration of fever ,and infection type were statistically significant ( P < 0 .05) .Prema‐ture rupture of membranes .(2) Logistic regression analysis showed that premature rupture of membranes , highest temperature ≥ 38 .5 ℃ ,age at time of fever is 14 days or less ,heating duration ≥ 3 d ,and bacterial infection are independent risk factors for neonatal cerebrospinal fluid abnormalities ( P < 0 .05) .Birth weight 2 .5 Kg or less is not an independent risk factor for neonatal cerebrospinal fluid abnormalities ( P > 0 .05) .Conclusion] For febrile newborns ,when premature rupture of membranes occurs during the mother's preg‐nancy ,age at time of fever is 14 days or less ,highest temperature is ≥ 38 .5 ℃ ,fever duration ≥ 3 d ,or diag‐nosis of bacterial infection ,the clinical doctors should give cerebrospinal fluid examination as soon as possible for the early diagnosis and treatment of intracranial infection .