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目的探讨新生儿细菌感染早期临床表现、血象变化及与围产期高危因素的关系。方法本院新生儿病房2004年1月至2009年8月诊断为新生儿感染的患儿为感染组,同期入院的非感染性患儿为对照组,每组不同发病日龄随机选出至少25例进行病例对照研究。分析新生儿细菌感染早期的临床表现、血象变化及与围产期高危因素间的关系。结果感染组患儿母亲胎盘绒毛膜炎、胎心率>160次/min或<120次/min、晚期减速、母亲产程中CRP>8mg/L的发生率明显高于对照组(P<0.05),其中母亲胎盘绒毛膜炎对感染的影响最大;感染组患儿体温>37.9℃的发生率高于对照组(P<0.05),其他症状、体征和对照组相比差异无统计学意义;出生后前3天发病的感染组患儿外周血WBC均明显高于对照组,差异有统计学意义(P<0.05),感染组患儿I/T比值平均为5.4%,明显高于对照组的2.4%,差异有统计学意义(P<0.05)。结论母亲胎盘绒毛膜炎、胎心率>160次/min或<120次/min、晚期减速、母亲产程中CRP>8mg/L是新生儿感染的高危因素;新生儿细菌感染早期无特异症状和体征;出生后前3天新生儿细菌感染早期的外周血白细胞总数有参考意义。
Objective To investigate the early clinical manifestations of neonatal bacterial infection, changes in blood and perinatal high risk factors. Methods The neonatal ward of our hospital was diagnosed as infected with neonatal infection from January 2004 to August 2009, and the noninfectious children admitted during the same period as the control group. Each group was randomly selected at least 25 days old Case-control study. Analysis of early neonatal bacterial clinical manifestations, changes in blood and perinatal high risk factors. Results The incidence of placental chorioamnion in the infected group was significantly higher than that of the control group (> 160 beats / min or <120 beats / min, late decelerations, and CRP> 8 mg / L) , Among which, maternal placental chorioenitis had the most significant impact on infection. The incidence of body temperature> 37.9 ℃ in infected group was higher than that in control group (P <0.05), while other symptoms and signs were not significantly different from those in control group. The WBC in peripheral blood of children with infection in the first 3 days after infection was significantly higher than that in the control group (P <0.05), and the I / T ratio in children with infection was 5.4%, which was significantly higher than that in the control group 2.4%, the difference was statistically significant (P <0.05). Conclusion Placental chorioamnion in mothers has a fetal heart rate> 160 beats / min or less than 120 beats / min, late decelerations and CRP> 8mg / L in the labor process are the risk factors of neonatal infection. Neonatal bacterial infection has no early symptoms and Signs; the first 3 days after birth, bacterial infection in early white blood cells in the total number of reference for reference.