目的 探讨新生儿败血症临床特点及其预后的相关影响因素。方法 选择深圳市龙华区人民医院2016-01至 2018-06的新生儿败血症147例,采集所有患儿血液标本,分离鉴定病原菌。分析新生儿败血症患儿临床表现和病原菌特点, 采用多因素分析影响新生儿败血症患儿预后危险因素。结果 新生儿败血症患儿147例,临床表现以反应差、面色灰白和呼吸困难为主。147例中培养病原菌106株,以革兰阴性菌为主,分离出59株;其次为革兰阳性菌,分离出43株。所有患儿根据相关感染指标检测及血培养后给予抗菌药物经验治疗,存活组109例,死亡组38例。经单因素分析表明,两组性别、年龄、精神状况、血压、尿量和WBC比较无统计学意义;两组低出生体重儿、早产儿、MODS、PLT和休克评分比较具有统计学意义(P＜0.05)。多因素Logistic回归分析显示,MODS (OR:1.532, 95%CI: 1.089~2.109) PLT( OR:2. 115,95% CI: 1.481~2.897)和休克评分(OR:1.809,95% CI: 1.276~2.468)为影响新生儿败血症患儿预后的独立危险因素。结论 新生儿败血症临床表现以反应差、面色灰白和呼吸困难为主,培养病原菌以革兰阴性菌为主,MODS、PLT和休克评分均是影响新生儿预后的相关危险因素,为改善患儿应采取针对性预防措施,值得临床借鉴。

Objective To explore the clinical characteristics of neonatal sepsis and determinants of prognosis. Methods One hundred and forty-seven cases of neonatal sepsis treated at Shenzhen Longhua District People’s Hospital between January 2016 and June 2018 were selected, whose blood specimens were collected to isolate and identify pathogenic bacteria. The clinical manifestations and characteristics of pathogenic bacteria of neonatal sepsis were analyzed, and the risk factors affecting the prognosis of children with neonatal sepsis were analyzed by multifactorial analysis. Results The clinical manifestations of 147 cases of neonatal sepsis were mainly poor response, pallor and dyspnea. A total of 106 strains of pathogenic bacteria were cultured in 147 cases, 59 of which were gram-negative bacteria and 43 were gram-positive bacteria. All the children were treated empirically with antimicrobial drugs according to the relevant infection indexes and blood culture. Children were divided into the surviving group (n=109) and dead group (n=38). Univariate analysis showed that gender, age, mental status, blood pressure, urine outputs and WBC were not significantly different between the two groups. However, the difference in the incidence low-birth-weight infants, preterm infants, MODS, PLT and shock scores was statistically significant between the two groups (P<0.05). Multifactorial logistic regression analysis showed that MODS (OR:1.532, 95% CI: 1.089-2.109), PLT (OR:2.115, 95% CI: 1.481-2.897) and shock scores (OR:1.809, 95% CI: 1.276-2.468) were independent risk factors affecting the prognosis of children with neonatal sepsis. Conclusions The clinical manifestations of neonatal sepsis are mostly poor response, pallor and dyspnea. The cultured pathogens are mainly gram-negative bacteria. MODS, PLT and shock scores are risk factors affecting the prognosis of neonates.