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目的研究新生儿败血症心肌损害的发生与其出生时状况的相关关系,以改善新生儿败血症的预后。方法采用前瞻性临床观察研究方法,对郑州大学第三附属医院NICU2005-11-15—2006-05-31收治的112例败血症新生儿心肌损害的发生与其出生时胎龄、体重、性别、产式及有无窒息史等状况的关系进行了相关性分析。结果112例患儿中发生心肌损害者57例(50.9%)。23例早产儿心肌损害的发生率为78.3%,显著高于足月儿(43.4%),早产与新生儿败血症心肌损害的发生有显著的正相关性(r=0.288,P<0.05);28例低出生体重儿心肌损害的发生率为67.9%,显著高于正常出生体重儿(45.2%),低出生体重与新生儿败血症心肌损害的发生有显著的正相关性(r=0.196,P<0.05);新生儿败血症合并窒息者34例,心肌损害的发生率为85.3%,显著高于无窒息者(35.9%),窒息与新生儿败血症心肌损害的发生有显著的正相关性(r=0.454,P<0.05)。而不同性别及分娩方式对患婴心肌损害的发生率无影响。结论早产、低体重、窒息是新生儿败血症发生心肌损害的3个高危因素,对于这些新生儿发生败血症时,更要关注其心肌损害的发生以降低病死率。
Objective To study the relationship between the occurrence of myocardial damage and neonatal sepsis at birth in order to improve the prognosis of neonatal sepsis. Methods The prospective clinical observation method was used to investigate the relationship between myocardial damage and the gestational age, weight, sex, And whether the history of asphyxia such as the relationship between the correlation analysis. Results 57 cases (50.9%) had cardiac damage in 112 children. The incidence of myocardial damage in preterm infants was 78.3%, significantly higher than that in term infants (43.4%). There was a significant positive correlation between myocardial damage and neonatal sepsis (r = 0.288, P <0.05). 28 The incidence of myocardial damage in low birth weight children was 67.9%, significantly higher than that of normal birth weight children (45.2%). There was a significant positive correlation between low birth weight and myocardial damage in neonatal sepsis (r = 0.196, P < 0.05). There were 34 cases of neonatal sepsis complicated with asphyxia, the incidence of myocardial damage was 85.3%, significantly higher than those without asphyxia (35.9%), asphyxia and neonatal sepsis myocardial damage was significantly positive correlation (r = 0.454, P <0.05). However, the gender and delivery mode had no effect on the incidence of myocardial damage in infants. Conclusions Preterm birth, low birth weight and asphyxia are the three risk factors of myocardial damage in neonatal sepsis. In these neonates, the occurrence of sepsis should be paid more attention to the occurrence of myocardial damage so as to reduce the mortality.