新生儿重症监护病房内早产儿真菌脓毒症危险因素分析与护理对策

陈虹

摘要目的：探讨新生儿重症监护病房内早产儿真菌脓毒症危险因素分析与护理对策。方法：2010年12月～2013年12月在我院新生儿重症监护病房内收治的真菌脓毒症早产儿的病例资料中随机抽取41例患儿作为研究对象，回顾分析其危险因素及护理对策。结果 ：本研究的41例患儿发生真菌感染的平均出生时间为(15.23±8.43)d，且主要集中为冬夏两季。其中有37例(90.24%)真菌感染时出现血小板下降，有22例(53.66%)经2次及以上血培养结果显示阳性，有39例(95.12%)经PICC培养结果显示为阴性。结论：早产儿真菌脓毒症危险因素与低体重、胎龄、胃肠外营养、留置导管、抗生素及呼吸机的使用等有关，而护理对策辅助抗真菌预防治疗，可大大降低其发生率和死亡率。

关键词新生儿；重症监护室；真菌；脓毒症doi:10.3969/j.issn.1672-9676.2015.08.054

收稿日期：(2014-08-07)

收稿日期：(2015-03-16)

Analysis of risk factors and nursing strategies of the fungal sepsis in premature infants in the neonatal intensive care unit

CHEN Hong(Heyuan Maternal and Child Health-Care Station，Heyuan517000)

AbstractObjective:To investigate the risk factors of fungal sepsis in neonatal intensive care unit and nursing countermeasures.Methods:From December 2010-December 2013,in the clinical data in our hospital neonatal intensive care unit from fungal sepsis in premature infants,randomly selected 41 cases as the object of study,a retrospective analysis of the risk factors and nursing countermeasure.Results:The incidence of the 41 cases fungal infection of the average time of birth for(15.23±8.43)d,and mainly for winter and summer.Including 37 cases (90.24%) fungus infection appear thrombocytopenia,22 cases (53.66%) by more than 2 times and blood culture results showed positive,39 cases (95.12%) through PICC culture results were negative.Conclusion:Premature fungal sepsis risk factors and low birth weight,gestational age,parenteral nutrition,lien catheter,antibiotics and mechanical ventilation and nursing countermeasures of auxiliary antifungal prophylaxis,can greatly reduce the incidence and mortality rate.

Key wordsNeonate;Critical care unit;Fungus;Sepsis

近年来，由于抗生素的大量使用以及其他医疗手段的频繁开展，致使我国新生儿真菌脓毒症的发生率急剧上升，特别是早产儿。早产儿是指孕期未满37周生产的新生儿[1]，在我国的发病率为10%，死亡率占新生儿总死亡率的75%～85%。随着医学技术的提高，大多数医院都建立了专门救治新生儿的特殊病房，即新生儿重症监护病房(NICU)。但是新生儿，尤其是早产儿，其自身的生理机能及免疫系统均尚未完善，极容易感染，从而导致真菌脓毒症的发生。为此，笔者就NICU内早产儿真菌脓毒症危险因素分析与护理对策进行探讨分析，旨在为本病的有效防治提高临床价值，现报道如下。……