新生儿败血症死亡病例的临床分析

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Abstract Objective To analyze the clinical characteristics of neonatal deaths with early-onset sepsis (EOS) and late-onset sepsis (LOS). Methods Data of neonatal sepsis cases hospitalized in Department of Neonatology, Guangdong Women and Children Hospital from January 2016 to December 2020 were retrospectively analyzed. According to the time of onset, they were divided into EOS group (38 cases) and LOS group (46 cases). Basic data (gender, gestational age, birth weight, perinatal related factors) and clinical characteristics (sepsis related test results, the incidence of complications) were compared between two groups. Results There were no significant differences in gender, gestational age, preterm, birth weight, extremely low birth weight infant, small for gestational age, cesarean section between two groups (P >0.05). The time from onset to death in EOS group was shorter than that in LOS group, and the difference was statistically significant (P < 0.05). There were no significant differences in the incidence of premature rupture of membranes ≥18 h, Ⅲ degree contamination of amniotic fluid, fetal distress, maternal age > 35 years old, maternal chorionic amniotis, and maternal infection in late pregnancy between two groups (P > 0.05). The detection rate of Klebsiella pneumoniae in EOS group was lower than that in LOS group; white blood cell count (WBC) <5×109/L and the incidence of WBC increase in EOS group were lower than those in LOS group, and the differences were statistically significant (P < 0.05). There were no significant differences in the incidence of platelet count (PLT) <100×109/L, PLT≤30×109/L, C-reactive protein ≥100 mg/L, procalcitonin ≥30 ng/ml and detection rate of group B streptococcus, Escherichia coli between two groups (P > 0.05). The incidence of neonatal necrotizing enterocolitis in EOS group was lower than that in LOS group, and the incidence of perinatal asphyxia was higher than that in LOS group, and the differences were statistically significant (P < 0.05). There were no significant differences in the incidence of bacterial meningitis, infectious pneumonia, neonatal hyperglycemia, neonatal hypoglycemia, and neonatal pulmonary hemorrhage between two groups (P > 0.05). Conclusion EOS and LOS in neonatal period have different risk factors, pathogens and complications, which should be paid more attention in clinical work.

Key words： Early-onset sepsis Late-onset sepsis Neonatal Death

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	YAN Huiheng1 LI Hui2 HE Qianmin1 WANG Yanli1 CHEN Yunbin1

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YAN Huiheng1 LI Hui2 HE Qianmin1 WANG Yanli1 CHEN Yunbin1. Clinical analysis of neonatal sepsis deaths[J]. 中国医药导报, 2021, 18(23): 84-87,103.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I23/84

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