| 摘要: |
| 目的：探讨早发型与晚发型新生儿败血症的临床特征，为新生儿科医师早期识别新生儿败血症提供参考。方法：选取2016年1月至2019年1月四川省科学城医院收治的新生儿早发型和晚发型败血症86例，比较分析其临床特征。根据不同发病时间分为早发型败血症组（≤72h）33例和晚发型败血症组（＞72h）53例。结果：早发型组早产儿、小于胎龄儿、胎膜早破、母亲产前感染、黄疸、硬肿、拒乳、感染性休克、弥漫性血管内凝血（DIC）和化脓性脑膜炎发生率明显高于晚发型组，而晚发型组院内感染、院外感染、体温异常发生率高于早发型组，差异均有统计学意义（P<0.05）。早发型败血症以G－菌为主，主要包括大肠埃希菌（37.5%）、肺炎克雷伯菌（25.0%）和凝固酶阴性葡萄球菌（18.75%）；晚发型败血症以G＋菌为主，主要包括凝固酶阴性葡萄球菌（33.33%）、B族链球菌（25.0%）和大肠埃希菌（20.83%）。结论：早发型败血症以G－菌、晚发型败血症以G＋菌感染为主。早产、围生期感染是新生儿早发型败血症的高危因素，做好围产期保健、减少围产期感染是预防新生儿败血症的重要环节。 |
| 关键词: 败血症 新生儿 早发型 晚发型 临床特征 病原学 |
| DOI：doi:10.13407/j.cnki.jpp.1672.108X.2021.08.010 |
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| 基金项目: |
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| Comparison of Clinical Features and Etiology between Early-Onset and Late-Onset Neonatal Sepsis |
| Deng Yibin1, He Na1, Wang Huimin1, Cheng Mingliang1, Wang Sufen1, Wang Xiaoyin2 |
| (1. Sichuan Science City Hospital, Sichuan Mianyang 621900, China; 2. Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan Chengdu 610072, China) |
| Abstract: |
| Objective: To probe into the clinical features of early-onset and late-onset neonatal sepsis, so as to provide references for neonatologists to identify neonatal sepsis in the early stage. Methods: Totally 86 cases of early-onset and late-onset neonatal sepsis admitted into Sichuan Science City Hospital from Jan. 2016 to Jan. 2019 were extracted. According to different onset time, all patients were divided into 33 cases in the early-onset sepsis group (≤72 h) and 53 cases in the late-onset sepsis group (>72 h). And the clinical features were compared and analyzed. Results: The incidences of premature, small for gestation age, premature rupture of membranes, maternal prenatal infection, jaundice, sclerosis, refusal of milk, septic shock, diffuse intravascular coagulation (DIC) and purulent meningitis in the early-onset group were significantly higher than those in the late-onset group, while the incidences of internal and external infections, and abnormal body temperature in the late-onset group were higher than those in the early-onset group, with statistically significant differences (P<0.05). Early-onset sepsis was mainly caused by G- bacteria, including Escherichia coli (37.5%), Klebsiella pneumoniae (25.0%) and coagulase-negative Staphylococci (18.75%). Late-onset sepsis was mainly caused by G+ bacteria, including coagulase-negative Staphylococci (33.33%), group B Streptococci (25.0%) and E. coli (20.83%). Conclusion: Early-onset sepsis is mainly caused by G- bacteria, and late-onset sepsis is mainly caused by G+ bacteria. Premature delivery and perinatal infection are high-risk factors for early-onset neonatal sepsis, and good perinatal health care and reduction of perinatal infection are important aspects of preventing neonatal sepsis. |
| Key words: sepsis neonates early-onset late-onset clinical features etiology |
