摘要
目的探讨新生儿肺炎的病原学特点及影响因素,为疾病治疗及预后提供参考价值。方法选取2022年1月—2024年3月兴化市人民医院收治住院的88例新生儿肺炎患儿作为研究对象,纳入研究组;同时收集同期88例未发生肺炎的新生儿作为对照组。采用单因素和多因素logistic回归分析新生儿肺炎的影响因素。结果在88例新生儿肺炎病原学检查中,占比最高的依次为呼吸道合胞病毒(18.18%)、肺炎支原体(13.64%)、大肠埃希菌(12.50%)、肺炎克雷伯菌(10.23%)。单因素分析显示,研究组羊水污染、胎儿窘迫、低体温、早产儿、使用抗菌药物预防、应用激素、气管插管、低蛋白血症、多种抗生素使用、流行性疾病接触史例数均高于对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,羊水污染(OR=1.274,95%CI 1.106~1.467)、胎儿窘迫(OR=1.531,95%CI 1.330~1.763)、低体温(OR=5.778,95%CI 5.047~6.614)、早产儿(OR=13.999,95%CI 3.978~49.270)、应用激素(OR=17.357,95%CI9.472~31.806)、气管插管(OR=2.599,95%CI 2.038~3.314)、低蛋白血症(OR=1.523,95%CI 1.197~1.939)、多种抗生素使用(OR=2.798,95%CI 1.352~5.790)、流行性疾病接触史(OR=30.326,95%CI 10.966~83.868)为新生儿肺炎的危险因素(P<0.05);而使用抗菌药物预防为新生儿肺炎的保护因素(P<0.05)。结论新生儿肺炎病原学以病毒感染最为多见,且新生儿肺炎临床症状不明显,难以做出病原学诊断。影响新生儿肺炎的危险因素有羊水污染、胎儿窘迫、低体温、早产儿、应用激素、气管插管、低蛋白血症、多种抗生素使用、流行性疾病接触史,临床应针对危险因素制订相应的预防对策。为避免新生儿肺炎的发生率上升,应在早期对胎儿多检测、及时筛查,注意母体健康度,避免因母体并发症导致的宫内感染等情况,亦可加强卫生防御、注意无菌操作以及加强免疫支持等措施以此改善患儿的疾病发生率。
Objective To explore the etiological characteristics and influencing factors of neonatal pneumonia,and provide reference value for the treatment and prognosis of the disease.Methods A total of 88 children with neonatal pneumonia who were admitted and hospitalized in Xinghua City People's Hospital from January 2022 to March 2024 were selected as the research subjects and included in the study group.Meanwhile,88 newborns without pneumonia during the same period were collected as the control group.Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of neonatal pneumonia.Results In the etiological examination of 88 cases of neonatal pneumonia,the highest proportions were respiratory syncytial virus(18.18%),mycoplasma pneumoniae(13.64%),Escherichia coli(12.50%),and Klebsiella pneumoniae(10.23%).Univariate analysis showed that the number of cases with amniotic fluid contamination,fetal distress,hypothermia,premature infants,prevention with antibacterial drugs,application of hormones,tracheal intubation,hypoproteinemia,the use of multiple antibiotics,and history of exposure to epidemic diseases in the study group were all higher than those in the control group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that amniotic fluid contamination(OR=1.274,95%CI 1.106-1.467),fetal distress(OR=1.531,95%CI 1.330-1.763),and hypothermia(OR=5.778,95%CI 5.047-6.614),premature infants(OR=13.999,95%CI 3.978-49.270),hormone application(OR=17.357,95%CI 9.472-31.806),tracheal intubation(OR=2.599,95%CI 2.038-3.314),hypoproteinemia(OR=1.523,95%CI 1.197-1.939),the use of multiple antibiotics(OR=2.798,95%CI 1.352-5.790),history of exposure to epidemic diseases(OR=30.326,95%CI 10.966-83.868)was a risk factor for neonatal pneumonia(P<0.05).The use of antibacterial drugs for prevention was a protective factor for neonatal pneumonia(P<0.05).Conclusion The etiology of neonatal pneumonia is most commonly viral infection,and the clinical symptoms of neonatal pneumonia are not obvious,making it difficult to make an etiological diagnosis.The risk factors influencing neonatal pneumonia include amniotic fluid contamination,fetal distress,hypothermia,premature birth,hormone application,tracheal intubation,hypoproteinemia,the use of multiple antibiotics,and history of exposure to epidemic diseases.Clinically,corresponding preventive countermeasures should be formulated for these risk factors.To prevent the rising incidence of neonatal pneumonia,it is necessary to conduct more tests and timely screenings on the fetus in the early stage,pay attention to the health of the mother,and avoid intrauterine infections and other situations caused by maternal complications.Measures such as strengthening hygiene defense,paying attention to aseptic operation,and enhancing immune support can also be taken to improve the disease incidence rate of the children.
作者
王彦彦
陈惠香
殷峥艳
朱兰
WANG Yanyan;CHEN Huixiang;YIN Zhengyan;ZHU Lan(Neonatal Intensive Care Unit,Xinghua City People's Hospital,Xinghua Jiangsu 225700,China)
出处
《中国卫生标准管理》
2025年第11期47-51,共5页
China Health Standard Management
关键词
新生儿肺炎
病原体分布
病原学特点
影响因素
高危因素
回归分析
neonatal pneumonia
pathogen distribution
etiological characteristics
influencing factors
high-risk factors
regression analysis
