论文部分内容阅读
目的探讨极低出生体重(VLBW)和超低出生体重(ELBW)早产儿发生真菌性败血症的危险因素,为其防控提供科学依据。方法选择2008年1月至2012年12月安徽医科大学第一附属医院新生儿科收治的VLBW/ELBW早产儿,根据住院期间是否发生真菌性败血症分为观察组和对照组。比较两组患儿的临床资料,对发生真菌性败血症可能的危险因素进行单因素分析及多因素Logistic回归分析。结果观察组36例,对照组163例。单因素分析显示,观察组胎龄<32周、新生儿呼吸窘迫综合征、肠道外营养≥14天、使用抗菌药物≥7天、联合使用抗菌药物、气管插管、经外周中心静脉置管(PICC)、PICC留置≥14天、机械通气、使用抑酸剂≥3天、小于胎龄儿的比例均高于对照组,单纯早产的比例低于对照组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,抗菌药物使用≥7天(OR=5.450,95%CI 1.712~17.356)、PICC留置≥14天(OR=6.314,95%CI 1.303~30.592)是发生真菌性败血症的独立危险因素。结论VLBW/ELBW早产儿真菌性败血症的危险因素多,合理使用抗菌药物、加强置管后护理是减少真菌性败血症的重要措施。
Objective To investigate the risk factors of fungal septicemia in preterm infants with very low birth weight (VLBW) and ultra-low birth weight (ELBW), and to provide a scientific basis for their prevention and control. Methods Preterm infants with VLBW / ELBW who were admitted to Department of Neonatology, the First Affiliated Hospital of Anhui Medical University from January 2008 to December 2012 were divided into observation group and control group according to whether there was fungal septicemia during hospitalization. The clinical data of two groups were compared, and the possible risk factors of fungal septicemia were analyzed by single factor and multivariate Logistic regression. Results The observation group 36 cases, control group 163 cases. Univariate analysis showed that observation group gestational age <32 weeks, neonatal respiratory distress syndrome, parenteral nutrition ≥ 14 days, the use of antimicrobial agents ≥ 7 days, combined antibiotics, endotracheal intubation, peripheral central venous catheterization PICC), PICC indwelling ≥14 days, mechanical ventilation, the use of antacids ≥3 days, the proportion of children less than gestational age were higher than the control group, the proportion of simple preterm birth was lower than the control group, the difference was statistically significant (P <0.05 ). Multivariate logistic regression analysis showed that the use of antibacterials for 7 days (OR = 5.450, 95% CI 1.712-17.356) and PICC for 14 days (OR = 6.314, 95% CI 1.303-30.592) Of independent risk factors. Conclusion There are many risk factors of fungal septicemia in VLBW / ELBW premature infants. It is an important measure to reduce fungal septicemia by using antimicrobial agents rationally and strengthening the nursing after catheterization.