新生儿重症监护病房早产儿感染的相关因素分析(1)
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2011年1月15日
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[摘要] 目的：分析本院新生儿重症监护病房(NICU)造成早产儿感染的菌株种类，了解细菌感染的临床表现，探讨新生儿感染的相关因素，为重症监护病房新生儿感染的预防与治疗提供依据。方法：从2008年5月～2010年5月转入本院NICU治疗的325例早产儿中筛选出76例院内感染的患儿，对其进行回顾性分析，主要内容为临床表现、实验室检查、细菌谱分析；并选取80例未感染的早产儿作为对照组，进行Logistic逐步回归分析，来筛选易感因素。 结果：导致NICU早产儿感染的病原菌主要为革兰阴性菌(80.6%)，其中最常见的为肺炎克雷伯杆菌，早期的临床症状有呼吸暂停、喂养不耐受、体温异常、黄疸消退延迟等。早产儿的易感因素主要为机械通气、静脉全营养、体重、胎龄、胎膜早破。结论：早产儿感染涉及的范围比较广，临床表现多样，某些缺乏典型性，故应密切关注，在给予抗生素治疗的过程中，应合理使用，对于合并感染因素较多的早产儿应进行预防性处理。
[关键词] 早产儿；重症监护病房；院内感染；肺炎克雷伯杆菌
[中图分类号] R722 [文献标识码]A[文章编号]1674-4721(2011)01(b)-036-03
Analysis of clinical influential factors among preterm infants in NICU
WANG Weiyuan, XU Min, WANG Fulan
(Department of Newborn Pediatrics, the Maternity Hospital of Suqian City, Jiangsu Province, Suqian 223800, China)
[Abstract] Objective: To analyze thestrains' types caused the infections of preterminfants inneonatal intensive care unit (NICU), to learn the clinical manifestations of bacterial infection and explore therelevant factor of the infections, so provide references for the clinicalprevention and therapy of preterminfants' infection. Methods: 76 cases of infection were chosen from 325 preterm infants admitted by our hospital from May 2008 to May 2010. Several items were investigated in the retrospective study, such as clinical manifestation, laboratory examinations, spectral analysisof thebacteria and curative effects. 80 cases of normal preterm infantswere chosen as control group, and the logistic regression were employed to screen the predisposing factors. Results: Gram-negative bacteria (80.6%) had caused the majority infections of preterm infants, and klebsiella pneumonia was the prevalent component. The early infection presentations include apnea, feeding intolerance, abnormal temperature, and delayed jaundice, et al. Predisposing factors in preterminfantsare mechanical ventilation, intravenous nutrition, weight, gestational age, premature rupture of membranes. Conclusion: Varieties of clinical manifestations are involved in the infections of preterminfants, because some lack of representativeness, so we should pay close attention ......
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