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目的探索一种简单、有效的对新生儿非严重细菌感染(serious bacterial infection,SBI)性发热性疾病的早期鉴别方法,为减少抗生素使用提供有效依据。方法选取2006年1月到2007年6月入住我科的发热新生儿为研究对象。病人情况完全符合预先确定的指标体系者视为SBI低危组,其他则归为SBI高危组,比较两组SBI发病率和两组病例入院后发热持续时间并推断该指标体系对SBI的阴性预测值(negative predictive value,NPV)。结果在153例发热新生儿中,SBI低危组共58例,仅2(3.45%)例最终被确诊为SBI;相对于SBI高危组95例中有51(53.68%)例确诊为SBI,其差异有统计学意义(P<0.001)。该指标体系对SBI的阴性预测值为96.55%(其95%可信区间为91.86%-100%)。结论该指标体系可简单、快速、可靠排除发热新生儿为SBI,具有一定临床指导意义。
Objective To explore a simple and effective early identification method of neonatal severe bacterial infection (SBI) febrile disease, and to provide an effective basis for reducing the use of antibiotics. Methods From January 2006 to June 2007, the newborn infants admitted to our department were studied. Patients with complete compliance with the pre-determined index system were considered SBI low-risk group, others were classified as SBI high-risk group, comparing the two groups of SBI incidence and fever duration after admission in both groups and infer the index system of SBI negative predictive Negative predictive value (NPV). Results Of the 153 neonates with fever, 58 (SBI) were low-risk group of SBI and only 2 (3.45%) were finally diagnosed as SBI. Compared with SBI, 51 (53.68%) of 95 patients were diagnosed as SBI The difference was statistically significant (P <0.001). The negative predictive value of this index system for SBI was 96.55% (95% confidence interval 91.86% -100%). Conclusion The index system can be a simple, rapid and reliable exclusion of fever in neonates as SBI, has some clinical significance.