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目的:对比观察早发型和晚发型新生儿大肠埃希菌败血症(ES)的临床表现、实验室指标、治疗及预后情况,为早期诊断与合理治疗ES提供依据。方法:选择40例新生儿ES患者进行回顾性分析,其中早发型18例,晚发型22例。收集所有患者的临床资料,取血进行实验室检查,分别对早发型ES和晚发型ES的临床表现、实验室指标、治疗和预后情况进行分析与比较。结果:早发型ES患儿主要为足月儿和近足月儿,晚发型ES患儿主要为早产儿、近足月儿和低出生体重儿;早发型ES以黄疸和呼吸暂停为最常见症状,晚发型ES以呼吸暂停、腹胀和呕吐为主要症状;与早发型ES比较,晚发型ES临床表现较严重,治愈率明显降低(P<0.01),而死亡率显著升高(P<0.05)。结论:大肠埃希菌是新生儿早发型和晚发型败血症的一种重要致病菌;晚发型ES易发生于早产儿和低出生体重儿,合并症发生率高,预后较差。
Objective: To compare the clinical manifestations, laboratory indexes, treatment and prognosis of early-onset and late-onset neonatal Escherichia coli sepsis (ES), and to provide evidence for early diagnosis and rational treatment of ES. Methods: Forty neonates with ES were selected retrospectively, including 18 cases of early onset and 22 cases of late onset. The clinical data of all patients were collected and the blood was collected for laboratory examination. The clinical manifestations, laboratory indexes, treatment and prognosis of early-onset ES and late-onset ES were respectively analyzed and compared. Results: Early-onset ES children were mainly full-term infants and nearly full-term infants, while late-onset ES children were mainly premature infants, nearly full-term infants and low birth weight infants. Early-onset ES was the most common symptom with jaundice and apnea , Late-onset ES with apnea, abdominal distension and vomiting as the main symptoms; compared with early-onset ES, the clinical manifestations of late-onset ES were more serious, the cure rate was significantly lower (P <0.01), while the mortality was significantly higher (P < . Conclusion: Escherichia coli is an important pathogen of early-onset and late-onset sepsis. Neonatal ES occurs in premature infants and low birth weight infants with high incidence and poor prognosis.