Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và một số yếu tố nguy cơ của nhiễm khuẩn sơ sinh sớm tại Bệnh viện Hữu Nghị Đa khoa Nghệ An=Clinical, subclinical features and risk factors of early onset neonatal infection at Nghe An General Friendship Hospital

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Tác giả: Văn Hậu Lê, Thị Thúy An Nguyễn, Thị Anh Thái Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.194-199

Bộ sưu tập: Metadata

ID: 477997

Thêm vào giỏ

Mô tả đặc điểm lâm sàng, cận lâm sàng và một số yếu tố nguy cơ của nhiễm khuẩn sơ sinh sớm. Phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang có nhóm chứng. Chọn mẫu ngẫu nhiên gồm những trẻ sơ sinh trong vòng 72 giờ đầu sau sinh nghi ngờ nhiễm khuẩn sơ sinh sớm. Sau đó, chia làm 2 nhóm: nhóm bệnh gồm 50 trẻ sơ sinh được chẩn đoán nhiễm khuẩn sơ sinh sớm và nhóm chứng gồm 50 trẻ sơ sinh đã loại trừ nhiễm khuẩn để so sánh. Kết quả: Trong nhóm đối tượng nhiễm khuẩn sơ sinh sớm, tỷ lệ trẻ nam chiếm 62%. Tỷ lệ trẻ sơ sinh non tháng là 36%. Tỷ lệ sinh mổ là 42%. Các triệu chứng lâm sàng của các cơ quan thường gặp ở trẻ mắc nhiễm khuẩn sơ sinh sớm là da niêm mạc (80%), hô hấp (72%), tiêu hóa (72%). Có 18% trẻ sơ sinh mắc nhiễm khuẩn sơ sinh sớm có tăng bạch cầu máu ngoại vi >
25 G/L, với trung vị là 20.3 G/L, cao hơn có ý nghĩa so với trẻ sơ sinh không mắc nhiễm khuẩn sơ sinh sớm (2%). Tỷ lệ trẻ sơ sinh mắc nhiễm khuẩn sơ sinh sớm có bạch cầu đa nhân trung tính máu ngoại vi >
13 G/L là 42%. Các yếu tố nguy cơ góp phần chẩn đoán nhiễm khuẩn sơ sinh sớm là mẹ tiền sản giật (OR:4.42), sinh non tự nhiên dưới 35 tuần (OR:4.42), ối vỡ kéo dài trên 18 giờ (OR:3.92). Cân nặng lúc sinh giảm đi 1000 gam sẽ làm tăng nguy cơ nhiễm khuẩn sơ sinh sớm lên 2.78 lần. Kết luận: Phối hợp các triệu chứng lâm sàng, cận lâm sàng và khai thác yếu tố nguy cơ sẽ giúp góp phần giúp chẩn đoán nhiễm khuẩn sơ sinh sớm.To describe clinical and paraclinical characteristics and risk factors associated with early-onset neonatal infection. Methods: A cross-sectional descriptive study with a control group. Random sampling included neonates suspected of early-onset neonatal infection within the first 72 hours after birth. The sample was divided into two groups: 50 neonates diagnosed with early-onset neonatal infection and a control group of 50 neonates without infection for comparison. Results: In the early-onset infection group, male infants accounted for 62%, preterm infants for 36%, and 42% were delivered by cesarean section. The most common clinical symptoms in infected neonates involved the skin and mucous membranes (80%), respiratory system (72%), and gastrointestinal system (72%). Additionally, 18% of neonates had elevated peripheral white blood cell counts >
25 G/L, with a median of 20.3 G/L, significantly higher compared to non-infected neonates (2%). Moreover, 42% of neonates with early-onset infection had peripheral neutrophil counts >
13 G/L. Risk factors contributing to early-onset neonatal infection diagnosis included maternal preeclampsia (OR: 4.42), spontaneous preterm birth before 35 weeks (OR: 4.42), and prolonged rupture of membranes (>
18 hours) (OR: 3.92). A 1000-gram decrease in birth weight increased the risk of early-onset neonatal infection by 2.78 times. Conclusion: Combining clinical symptoms, paraclinical findings, and risk factors enhances the diagnosis of early-onset neonatal infection.

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