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目的 探讨新生儿寒冷损伤与全身炎症反应综合征 (SIRS)发生的关系。方法 对 6 0例以寒冷损伤综合征为原发病并排除合并感染的新生儿 ,根据SIRS的发生与否分SIRS组及非SIRS组 ,比较两组入院时体温、复温时间 (低温持续时间 ) ,复温速度及其多器官功能障碍综合征 (MODS)发生率、病死率 ;并比较不同体温患儿SIRS和MODS发生率、病死率 ;比较SIRS组中符合SIRS项目数与存活率的关系 ;以及两组发生MODS的具体脏器分布的差异。结果 SIRS组复温时间较非SIRS组长 (P <0 0 5 ) ,复温速度比非SIRS组慢 (P <0 0 5 ) ,MODS发生率SIRS组比非SIRS组明显升高 (P <0 0 5 ) ,病死率比较无显著性差异。不同体温组中SIRS及MODS发生率、病死率比较差异具有显著性意义 ,体温越低 ,SIRS及MODS发生率、病死率越高。发生 3个以上器官损害患儿的病死率较 2个器官损害患儿的病死率高。结论 在新生儿寒冷损伤综合征中 ,SIRS及MODS的发生、发展与低体温严重程度及持续时间密切相关。
Objective To investigate the relationship between neonatal cold injury and systemic inflammatory response syndrome (SIRS). Methods Sixty newborns with cold injury syndrome as the primary disease and with complicated infection were excluded. According to whether SIRS occurred or not, the body temperature, rewarming time (low temperature duration ), The rate of rewarming and the incidence of multiple organ dysfunction syndrome (MODS) and mortality; and SIRS and MODS incidence and mortality in children with different body temperature were compared; the relationship between the number of SIRS-eligible SIRS patients and the survival rate was compared ; And differences in the distribution of specific organs in the two groups that developed MODS. Results The rewarming time of SIRS group was longer than that of non - SIRS group (P <0.05), and the rewarming rate was slower than that of non - SIRS group (P <0.05). The incidence of MODS in SIRS group was significantly higher than that of non - SIRS group (P < 0 0 5), no significant difference in mortality. The body temperature in different groups of SIRS and MODS, the mortality was significantly different, the lower the body temperature, the incidence of SIRS and MODS, the higher mortality. More than 3 cases of organ damage in children with mortality than 2 organ damage in children with high mortality. Conclusion The incidence and development of SIRS and MODS in neonatal cold injury syndrome are closely related to the severity and duration of hypothermia.