【论文关键词】败血症;新生儿;检验
【论文摘要】目的:总结新生儿败血症的临床表现,并研究了其病原菌分布和临床抗生素耐药性状况,为治疗及降低新生儿败血症病死率提供依据。方法:对收治的21例新生儿败血症的临床资料和实验室检查及药敏试验进行回顾性分析。结果:新生儿败血症临床表现无特异性,以体温异常、黄疸、精神萎靡等为主。21例血标本中分离出21株病原菌,其中革兰氏阳性菌15株,药敏试验发现大多数菌株对青霉素和氨苄西林耐药,对头孢菌素类也有不同程度的耐药性,对万古霉素和喹诺酮类抗生素较敏感。结论:新生儿败血症临床表现无特异性,凝固酶阴性的葡萄球菌感染率上升,应及早进行实验室检查并通过药敏试验选择抗生素综合治疗。
21 cases of neonatal sepsis clinical analysis
【Abstract】Objective: To summarize the clinical manifestations of neonatal sepsis and to study the pathogen distribution and antibiotic resistance of clinical conditions, for the treatment and reduce mortality provide the basis for neonatal sepsis. Methods: 21 cases admitted to neonatal sepsis in the clinical data and laboratory tests and drug sensitivity test were analyzed retrospectively. Results: The clinical manifestations of neonatal sepsis without specific abnormalities in body temperature, jaundice, and other mainly make them apathetic. Blood specimens from 21 cases of isolated 21 pathogens, including gram-positive bacteria 15, sensitivity test found that the majority of strains resistant to penicillin and ampicillin, and cephalosporins have varying degrees of resistance to vancomycin mycophenolate Su-sensitive and quinolone antibiotics. Conclusion: The clinical manifestations of neonatal sepsis without specific coagulase-negative staphylococcal infection of the increase in laboratory tests should be conducted as soon as possible through the choice of antibiotic sensitivity test comprehensive treatment.
【Keywords】neonatal sepsis test
败血症是新生儿最严重的感染性疾病,常无特异性临床表现,误诊漏诊易造成新生儿死亡及严重后果。本病发病率及病死率高,是造成新生儿死亡的主要原因之一[1]。现将我院2006-2008年收治的21例败血症患儿资料分析如下。
1临床资料
1.1一般资料21例患儿均符合败血症诊断标准。其中男13例,信捷职称论文写作发表网,女8例;早产儿5例,足月儿16例;体重≤1500g 1例,1500~2500g 12例,≥2500g 8例;自然分娩15例,剖宫产6例;发病年龄0~7天12例,8~l4天7例,>14天2例;感染因素:羊膜早破4例,胎儿窘迫3例,皮肤黏膜感染1例,脐炎3例,上呼吸道感染4例,孕母感染3例,原因不明2例。
1.2主要临床表现进食减少9例,呕吐12例,发热8例,体温不升10例,黄疸13例,发绀4例,腹胀8例,呼吸困难4例,肝脾肿大5例,皮肤硬肿7例。
1.3治疗及结果通过血培养和药敏试验的结果选用适当的抗生素,同时进行积极支持与对症治疗,治愈17例;放弃1例;死亡3例;其中早产儿2例,足月儿1例。