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【目的】分析新生儿败血症临床表现、实验室检查与围生期高危因素的关系,为临床诊治提供科学依据。【方法】以本院67例新生儿败血症患儿为研究组,同期入院的非感染性患儿75例为对照组,对新生儿败血症的临床特点进行回顾性分析。【结果】胎膜早破>18 h、早产儿低体重儿及胎心晚期减速是新生儿败血症的高危因素。败血症患儿体温不升或发热、反应差、腹泻、腹胀、黄疸退而复现或加重、新生儿硬肿及心律失常的发生率明显高于对照组。败血症组患儿外周血WBC>20×109或WBC<5×109、I/T≥0.2、PLT<100×109及快速C-反应蛋白(C-reactcve protein,CRP)>8 mg/L明显高于对照组,差异有统计学意义。【结论】胎心晚期减速、早产儿低出生体重儿及胎膜早破是新生儿败血症的主要高危因素。血培养联合应用外周WBC、I/T、PLT、CRP有助于新生儿败血症的早期诊断。
【Objective】 To analyze the relationship between neonatal sepsis clinical manifestations, laboratory tests and risk factors during perinatal period, and provide a scientific basis for clinical diagnosis and treatment. 【Methods】 A total of 67 neonates with sepsis in our hospital were selected as research group. 75 non-infected children were enrolled in this study as control group. The clinical features of neonatal sepsis were analyzed retrospectively. 【Results】 Premature rupture of membranes> 18 h, low birth weight premature children and late fetal heart rate deceleration risk factors for neonatal sepsis. Children with sepsis temperature does not rise or fever, poor response, diarrhea, bloating, jaundice returned or aggravated, the incidence of neonatal edema and arrhythmia was significantly higher than the control group. The peripheral blood WBC> 20 × 109 or WBC <5 × 109, I / T≥0.2, PLT <100 × 109 and C-reactcve protein (CRP)> 8 mg / L were significantly higher in the sepsis group In the control group, the difference was statistically significant. 【Conclusion】 The late fetal heart rate retardation, premature infants with low birth weight and premature rupture of membranes is the main risk factor for neonatal sepsis. Blood culture combined with peripheral WBC, I / T, PLT, CRP contribute to the early diagnosis of neonatal sepsis.