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目的探讨新生儿B族链球菌(GBS)败血症的临床特点及预后情况。方法收集2011年1月至2014年10月本院新生儿科收治的GBS败血症新生儿资料,回顾性分析其临床表现、实验室检查、治疗效果及转归情况。结果新生儿GBS败血症共15例,早发型10例,晚发型5例。早发型病例多在生后24 h内发病,其中2例有胎膜早破病史,临床表现以呼吸道症状为主,死亡3例,表现为严重呼吸窘迫综合征、肺出血、休克、弥散性血管内凝血(DIC)等。晚发型病例多伴有化脓性脑膜炎,其中1例表现为持续应激性高血糖。GBS败血症患儿实验室检查可出现明显异常,可出现白细胞降低或增高,CRP明显增高,心肝肾功能异常,贫血,DIC等。随访:15例病例中死亡3例,12例存活病例随访至生后18个月均无明显精神运动发育落后。结论新生儿无乳链球菌败血症病情重,进展快,死亡率较高,治疗上应早期足量予使用敏感抗生素如青霉素、万古霉素等。
Objective To investigate the clinical features and prognosis of neonatal B streptococcal (GBS) sepsis. Methods The data of neonates with GBS sepsis admitted to neonatology department of our hospital from January 2011 to October 2014 were retrospectively analyzed. The clinical manifestations, laboratory tests, therapeutic effects and outcome were retrospectively analyzed. Results A total of 15 cases of neonatal GBS sepsis, early onset in 10 cases, 5 cases of late onset. More cases of early onset of onset within 24 hours after birth, including 2 cases of premature rupture of membranes, the clinical manifestations of respiratory symptoms, 3 patients died, manifested as severe respiratory distress syndrome, pulmonary hemorrhage, shock, disseminated vascular Internal coagulation (DIC) and so on. Late-onset cases were mostly associated with purulent meningitis, of which 1 case of persistent stress hyperglycemia. GBS sepsis in children with laboratory tests can be significant abnormalities may occur leukopenia or increased CRP was significantly higher heart and liver dysfunction anemia DIC and so on. Follow-up: There were 3 deaths in 15 cases and 12 cases survived after follow-up to 18 months after birth. Conclusion Neonatal Streptococcus agalactiae sepsis is seriously ill, with rapid progression and high mortality rate. Sensitive antibiotics such as penicillin and vancomycin should be used in early stage of treatment.