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目的分析新生儿长期发热病因,以期为早期诊断及早期治疗提供临床依据。方法选择2004年1月至2013年12月本院新生儿中心住院,且符合新生儿长期发热纳入标准,对患儿一般情况及病因进行回顾性分析。结果共纳入患儿238例,男165例,女73例。其中肺炎196例、皮肤黏膜感染67例、败血症46例、脑膜炎/脑炎25例、新生儿坏死性小肠结肠炎24例是最常见病因,尿崩症4例是唯一非感染病因。脑膜炎/脑炎、败血症、尿崩症、免疫缺陷病及泌尿系感染患儿更易出现高热(P<0.05)。肺炎患儿热型更易呈稽留热型或其他特殊热型(χ~2=4.581,P=0.032)。晚期出现长期发热新生儿更易罹患败血症、感染性腹泻、脑膜炎/脑炎等疾病(P<0.05)。结论感染性疾病是新生儿长期发热最主要病因,尿崩症是唯一非感染因素。
Objective To analyze the etiology of neonatal long-term fever in order to provide a clinical basis for early diagnosis and early treatment. Methods From January 2004 to December 2013, our hospital neonatal center was hospitalized and accorded with the long-term neonatal inclusion criteria. The general condition and etiology of the neonates were retrospectively analyzed. Results A total of 238 children were enrolled, including 165 males and 73 females. Among them, 196 cases of pneumonia, 67 cases of mucocutaneous infection, 46 cases of sepsis, 25 cases of meningitis / encephalitis, neonatal necrotizing enterocolitis 24 cases are the most common cause, diabetes insipidus 4 cases is the only non-infectious cause. Meningitis / encephalitis, septicemia, diabetes insipidus, immunodeficiency and urinary tract infections were more likely to develop hyperthermia (P <0.05). Children with pneumonia were more likely to have pyretic or other special type of fever (χ ~ 2 = 4.581, P = 0.032). Newborns with long-term fever in late stage are more likely to develop sepsis, infectious diarrhea, meningitis / encephalitis and other diseases (P <0.05). Conclusion Infectious disease is the most important cause of long-term neonatal fever, and diabetes insipidus is the only non-infectious factor.