新生儿细菌性肺炎82例高危因素分析及防治

    Risk factors for bacterial pneumonia in neonates and the protective measures: A report of 82 cases

    • 摘要: 目的:探讨新生儿细菌性肺炎发病的高危因素和防治方法。方法:对2004~2005年发病的新生儿82例早期、晚期细菌性肺炎高危因素、痰培养及药敏结果作一回顾性分析。结果:胎膜早破、窒息、低体温、气管插管、机械通气、早产和羊水污染等危害因素在新生儿肺炎早期发病组(≤ 7天发病)均高于晚期发病组(>7天发病)(P<0.05~P<0.01);上呼吸道感染病史或接触史在新生儿早期发病组低于晚期发病组,两者差异有统计学意义(P<0.01);不当沐浴、捂热在新生儿早期发病组及晚期发病组所占比例均无统计学意义(P>0.05);G-杆菌是细菌性肺炎的主要致病菌,克雷伯杆菌居于首位(25.61%),其余致病菌中链球菌为24.39%,肠杆菌为13.41%,假单胞菌为13.41%,沙雷菌为10.98%,大肠埃希菌为3.66%。呼吸机相关性肺炎(VAP)占12.20%。结论:进一步加强围产期保健和新生儿转运系统的建设,早产儿尽量实行"宫内转运",重视VAP的防治,做好新生儿家庭保健宣教,对于减少细菌性肺炎的发生有着重大意义。

       

      Abstract: Objective: To analyze the risk factors for bacterial pneumonia in neonates and to find the protective measures.Methods: The risk factors,sputum-culture and drug-sensitivity of 82 infants with bacterial pneumonia were analyzed retrospectively.The samples were collected from January 2004 to January 2005.Results: The incidence of fetal membrane premature rupture,asphyxia,low-temperature,ventilation,premature delivery and pollution of amniotic fluid was higher in the early-onset pneumonia group than that of late-onset group.Fewer infants had upper respiratory infection or contact history in the early-onset group.There was no significant difference between the two groups in the incidence of non-proper bath or muggy syndrome(P>0.05).Gram-negative bacteria(70.73%) were the main organisms in the bacteria pneumonia.Klebsiella(25.61%) was the most common bacterium.The other pathogenic bacteria were Streptococcus(24.39%),Enterobacter(13.41%),Pseudomonas(13.41%),Salmonella(10.98%) and Escherichia coli(3.66%).Ventilation-associated pneumonia(VAP) accounted for 12.20%.Conclusions: Intensive health care in perinatal period,intrauterine transportation for premature infants,prevention and treatment of VAP,and health education to the parents are essential for the prevention of bacterial pneumonia in neonates.

       

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