早发型及晚发型新生儿败血症临床高危因素对比.doc

早发型及晚发型新生儿败血症临床高危因素对比 　　【摘要】 目的：研究新生儿早发型败血症和晚发型败血症临床特点的异同，为早期诊断和治疗新生儿败血症提供依据。方法：回顾性分析2015年1月-2016年6月本院诊断新生儿败血症的153例患儿临床资料，对搜集的临床危险因素进行统计分析。结果：早发型败血症占新生儿败血症总发病人数的38.56%，晚发型败血症占61.44%。与晚发型败血症相比，早发型败血症中早产和低出生体重儿比例更低，OR分别为0.481、0.478；母亲胎膜早破及发热的比例较高，OR分别为2.270、3.529；与晚发型败血症相比，早发型败血症患儿中呼吸暂停及喂养不耐受的比例低，OR分别为0.410、0.400；辅助检查上，早发型败血症较晚发型败血症更容易出现血小板减少，OR为2.438。结论：早产儿、低出生体重儿、患儿出现呼吸暂停及喂养不耐受时需特别注意晚发型败血症的发生；而母亲发热、胎膜早破、血小板减少的患儿需警惕早发型败血症的发生 【关键词】 新生儿； 早发型败血症； 晚发型败血症； 临床特点 Comparison of Clinical Risk Factors for Early Onset and Late Onset Neonatal Sepsis/MIAO Po，SUN Bin，FENG Xing.//Medical Innovation of China，2016，13（35）：042-046 【Abstract】 Objective：To study the clinical features of neonatal early-onset sepsis and late-onset sepsis，and to provide useful data for the early diagnosis and treatment of neonatal sepsis.Method：A total of 153 cases of neonatal sepsis were analyzed retrospectively from Jan 2015 to Jun 2016，the risk factors were statistically analyzed.Result：Early-onset sepsis accounted for 38.56%，late-onset sepsis accounted for 61.44%.Compared to late-onset sepsis，the proportion of premature and low birth weight infants was lower in early-onset sepsis，OR were 0.481 and 0.478.The proportion of premature rupture of membranes and fever was high，OR were 2.270 and 3.529.Compared to early-onset sepsis，the proportion of apnea and feeding intolerance was lower in late-onset sepsis，OR were 0.410 and 0.400.Thrombocytopenia was common present in early-onset sepsis，OR was 2.438.Conclusion：We should be alert to late-onset sepsis when the infants are premature，low birth weight or suffer with apnea and feeding intolerance，while early-onset sepsis is more likely happened in infants who get thrombocytopenia，or mother get premature rupture of membranes and fever. 【Key words】 Newborn； Early-onset sepsis； Late-onset sepsis； Clinical risk factor First-authors address：Soochow University Affiliated Childrens Hospital，Suzhou 215025，China doi：10.3969/j.issn.1674-4985.2016.35.011