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目的分析极低出生体重儿(VLBWI)细菌感染的临床表现,探讨其相关临床影响因素。方法2006年1月至2007年1月出生24h转入新生儿科的VLBWI121例作为研究对象,记录患儿病情变化时的临床表现及实验室检查结果,并通过统计学方法得出其相关临床影响因素。结果住院期间感染43例共68例次,感染发生率为56.2%(68/121)。感染1次者21例,≥2次者22例。确定诊断7例次,临床诊断61例次。其中早发感染(感染发生于生后48～72h)14例次(14/121、11.6%);迟发感染54例次(感染发生于72h后)(54/121、44.6%)。出生体质量<1kg的感染率为90%(9/10),≥1kg感染率为53.2%(59/111)。感染早期临床表现主要为频繁呼吸暂停、喂养不耐受,肤色晦暗或皮肤有花纹并伴低体温,腹胀、体质量不增,呼吸窘迫等。运用Lo-gistic回归模型分析,其中胎膜早破、出生体质量<1kg、胎龄<32周、机械通气、置留胃管等均与早产儿感染有关。结论多因素导致住院VLBWI发生感染,应根据临床特点早期发现、积极治疗。
Objective To analyze the clinical manifestations of bacterial infection in very low birth weight infants (VLBWI) and to explore the related clinical influential factors. Methods One hundred and twelve cases of VLBWI transferred to neonatology from January 2006 to January 2007 were enrolled in this study. The clinical manifestations and laboratory findings of children with changes of disease were recorded. The related clinical influencing factors . Results In hospital infection 43 cases a total of 68 cases, the infection rate was 56.2% (68/121). Infection in 21 cases, ≥2 times in 22 cases. Confirm the diagnosis of 7 cases, 61 cases of clinical diagnosis. Among them, 14 cases (14/121, 11.6%) had early-onset infection (48 to 72 hours after birth), 54 cases delayed infection (54/121 and 44.6% after 72 hours). The prevalence of birth weight <1 kg was 90% (9/10), and the prevalence of ≥ 1 kg was 53.2% (59/111). Early clinical manifestations of infection are mainly frequent apnea, feeding intolerance, dull skin or skin pattern with hypothermia, bloating, body mass does not increase, respiratory distress. Lo-gistic regression model analysis, including premature rupture of membranes, birth weight <1kg, gestational age <32 weeks, mechanical ventilation, gastric placement and so on are related to premature children infection. Conclusions Multifactorial causes of VLBWI infection in hospital should be based on clinical features early detection and active treatment.