标题：早发型及晚发型新生儿败血症临床分析

      作者：姬婷婷 1，杨莹莹 2，赵力芳 1    1.延安市中医医院儿科，陕西 延安 716000；2.延安大学附属医院新生儿科，陕西 延安 716000

      卷次： 2021年32卷21期

      【摘要】 目的 比较早发型败血症(EOS)及晚发型败血症(LOS)新生儿的临床特征、病原体分布及外周血白细胞计数(WBC)、C-反应蛋白(CRP)表达水平，为新生儿败血症的诊断及预后判断提供参考。方法 回顾性分析延安大学附属医院 2019年 1月至 2021年 1月收治的 62例败血症新生儿的临床资料，根据败血症发生时间，将其分为 EOS组(n=38)和 LOS组(n=24)，比较两组患儿的临床特征、病原体分布、药敏分析结果、血生化指标及预后转归情况。结果 EOS组中胎龄≥37周的患儿占比为 68.42%，明显高于 LOS组的 25.00%，差异有统计学意义 (P<0.05)，EOS组患儿出生体质量为(2.51±0.47) kg，明显重于LOS组的(1.86±0.33) kg，差异有统计学意义(P<0.05)；两组患儿的母亲妊娠期高血压、胎膜早破、窒息史、机械通气史及经外周静脉置管率比较差异均有统计学意义(P<0.05)；EOS组患儿的呼吸窘迫占比为10.53%，明显低于LOS组的58.33%，新生儿坏死性小肠结肠炎发生率为21.05%，明显低于LOS组的62.50%，差异均有统计学意义(P<0.05)；62份血细菌培养标本中共分离出62株病原菌，其中革兰阳性菌 32株(51.61%)，革兰阴性菌 27株(43.54%)，真菌 2株(4.34%)；EOS组患儿检测出革兰阳性菌 26株(68.42%)，明显多于 LOS组的 6株(25.00%)，而患儿检测出革兰阴性菌 11株(28.95%)，明显少于 LOS组的 16株(66.67%)，差异均有统计学意义(P<0.05)；EOS组患儿的WBC水平为(14.22±3.34)×109/L，明显低于 LOS组的(18.63±3.74)×109/L；CRP水平为(9.11±1.36) mg/L，明显高于LOS组的(6.69±1.08) mg/L，差异均有统计学意义(P<0.05)；两组患儿的预后转归比较差异无统计学意义(P>0.05)。结论 EOS及LOS新生儿的临床特点、危险因素及病原学检测结果等均存在差异。此外，WBC下降、CRP水平升高等血生化检查指标在提示EOS中也具有一定的价值。
      【关键词】 新生儿；早发型败血症；晚发型败血症；病原体分布；白细胞计数；C反应蛋白
      【中图分类号】 R722.13+1 【文献标识码】 A 【文章编号】 1003—6350（2021）21—2775—04

Clinical analysis of early-onset and late-onset neonatal sepsis.
JI Ting-ting 1, YANG Ying-ying 2, ZHAO Li-fang 1.1. Department of Paediatrics, Yan'an Hospital of TCM, Yan'an 716000, Shaanxi, CHINA; 2. Department of Neonatology,Affiliated Hospital of Yan'an University, Yan'an 716000, Shaanxi, CHINA
【Abstract】 Objective To compare the clinical characteristics, pathogen distribution, white blood cell count(WBC), and C-reactive protein (CRP) expression levels in peripheral blood of early-onset sepsis (EOS) and late onsetsepsis (LOS) in neonates, and to provide a reference for the clinical diagnosis and prognosis evaluation of neonatal sep-sis. Methods The clinical data of 62 neonates with sepsis in Affiliated Hospital of Yan'an university from January 2019to January 2021 were retrospectively analyzed. According to the onset times of sepsis, newborns were divided into EOSgroup (n=38) and LOS group (n=24). The clinical characteristics, pathogen distribution, drug sensitivity results, biochem-ical indexes, and prognosis were compared between two groups. Results The proportion of gestational age≥37 weekswas 68.42% in EOS group, which was significantly higher than 25.00% in LOS group (P<0.05), and the birth weight ofEOS group was (2.51±0.47) kg, which was significantly higher than (1.86±0.33) kg in LOS group (P<0.05). The rates ofmaternal gestational hypertension, premature rupture of membranes, history of asphyxia, history of mechanical ventila-