论文部分内容阅读
目的探讨新生儿真菌性败血症的临床特点,以提高该疾病的诊治水平。方法选择2009—2011年我院新生儿重症监护病房收治的新生儿真菌性败血症病例,对患儿的一般状况、发病时间、首发症状、血培养结果、感染指标进行回顾性分析,比较治疗前与治疗中、治疗后血白细胞、血小板、C反应蛋白的变化情况。结果新生儿真菌性败血症的病原菌以白色念珠菌为主,发病日龄为生后5～29天,平均(11.5±9.9)天;频繁呼吸暂停、反应差、喂养不耐受、少动、发热是新生儿真菌性败血症的常见首发症状;多数患儿出现血小板减少、C反应蛋白增高,抗真菌治疗3天后多数患儿血小板可恢复正常,治疗1周后CRP可恢复正常,而WBC变化不明显,治疗前与治疗中、治疗后比较差异无统计学意义;应用氟康唑治疗新生儿念珠菌性败血症可取得满意疗效。结论新生儿真菌性败血症的临床表现缺乏特异性,对有高危因素的新生儿应高度警惕真菌感染的可能性,早期发现、及时治疗是治疗成功的关键。
Objective To investigate the clinical features of neonatal fungal sepsis to improve the diagnosis and treatment of the disease. Methods 2009 - neonatal fungal septicemia cases in 2011 in our hospital neonatal intensive care wards, and the general condition of the children, time of onset, initial symptoms, blood culture results, indicators of infection were retrospectively analyzed, and compared before treatment Treatment, the treatment of white blood cells, platelets, C-reactive protein changes. Results neonatal sepsis fungal pathogens Candida albicans, 5 to 29 days after onset day living, mean (11.5 ± 9.9) days; frequent apnea, poor response, feeding intolerance, lack of exercise, heat first symptom is a common fungal neonatal sepsis; most patients thrombocytopenia, C-reactive protein and blood platelet anti-fungal treatment most patients return to normal after 3 days, 1 week after treatment return to normal CRP, WBC and did not change significantly , Before treatment and during treatment, no significant difference after treatment; application of fluconazole treatment of neonatal Candida septicemia can achieve satisfactory results. Conclusion Neonatal fungal sepsis clinical manifestations of the lack of specificity, risk factors for newborns should be highly alert to the possibility of fungal infection, early detection and timely treatment is the key to the success of treatment.