[腰椎穿刺在低出生体重新生儿晚发性败血症评估中的应用]
[Use of lumbar puncture in the evaluation of late-onset sepsis in low birth weight neonates].
作者信息
Zea-Vera Alonso, Turín Christie Gloria, Rueda María Susana, Guillén-Pinto Daniel, Medina-Alva Pilar, Tori Aldredo, Rivas María, Zegarra Jaime, Castañeda Anne, Cam Luis, Ochoa Theresa J
出版信息
Rev Peru Med Exp Salud Publica. 2016 Jun;33(2):278-82.
The objective of this study was to analyze the use of lumbar punctures (LP) in the evaluation of late-onset neonatal sepsis. It is recommended to perform an LP as part of the evaluation of late-onset sepsis. We used a cohort of 414 newborns with a birth weight <2000g in three hospitals in Lima. A LP was performed in 45/214 (21.0%) of sepsis evaluations and in 13/48 (27.1%) of culture-proven sepsis. Meningitis was diagnosed in 8/214 (3.7%) of the episodes and 8/45 (17.5%) of the evaluations that included an LP. The duration of treatment of the sepsis episodes without a LP and the episodes with a negative LP was similar, and shorter than the episodes with a positive LP. The use of LP in the evaluation of late-onset sepsis is low and can result in undiagnosed and undertreated meningitis. The use of LP in the evaluation of neonatal sepsis must be encouraged in the neonatal units.
本研究的目的是分析腰椎穿刺（LP）在晚发型新生儿败血症评估中的应用情况。建议将LP作为晚发型败血症评估的一部分。我们对利马三家医院中414名出生体重<2000g的新生儿进行了队列研究。在214例败血症评估中有45例（21.0%）进行了LP，在48例血培养确诊的败血症中有13例（27.1%）进行了LP。在214例病例中有8例（3.7%）诊断为脑膜炎，在包括LP的45例评估中有8例（17.5%）诊断为脑膜炎。未进行LP的败血症病例以及LP结果为阴性的病例的治疗时间相似，且短于LP结果为阳性的病例。LP在晚发型败血症评估中的应用率较低，可能导致脑膜炎漏诊和治疗不足。新生儿病房必须鼓励在新生儿败血症评估中使用LP。
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