Kumar Ritesh, Addagatla Rajasekhar, Jaglan Sandeep Kumar, Divya Gali, Jaju Rishabh, Debnath Pinaki Ranjan, Sen Amita, Shah Shalu
Department of General Surgery, ANIIMS and G. B. Pant Hospital, Port Blair, Andaman and Nicobar Islands, India.
Department of Paediatric Surgery, ABVIMS and Dr. RML Hospital, New Delhi, India.
J Indian Assoc Pediatr Surg. 2022 Nov-Dec;27(6):677-683. doi: 10.4103/jiaps.jiaps_16_22. Epub 2022 Nov 14.
The aim of this study was to evaluate the early indicators of sepsis (sepsis screening) and their statistical correlation with sepsis in neonatal abdominal surgery.
A prospective observational study was performed on thirty consecutive neonate cases aged between 0 and 28 days with surgical abdomen at the Paediatric Surgery Department, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi. The study duration was 18 months. Septic screening was done in all neonates on day 0, 1, 3, 7, and 14 days of surgery with serum procalcitonin, C-reactive protein, total leukocyte count, immature/total neutrophil ratio, and microerythrocyte sedimentation rate. A septic screening-positive patient (three or more positive parameters out of five) was correlated with sepsis and analysis was done.
A total of 30 neonates of abdominal surgical cases were included consequently, out of which 56.7% ( = 17) were male and 43.3% ( = 13) were female. Maximum cases were of congenital diaphragmatic hernia 20% ( = 6) and then anorectal malformation 16.7% ( = 5). About 70% of neonates were sepsis screening positive. Fifty percentage of neonates were diagnosed to have sepsis on the clinical or laboratory findings, so sensitivity and specificity of sepsis screening were 93.33% and 40%, respectively. There was total 30% mortality in this study.
Sepsis screening is an early marker of sepsis, which can be used to help in early detection of neonatal surgical sepsis and timely intervention that can lead to decrease mortality and morbidity in neonatal surgery.
本研究旨在评估脓毒症的早期指标(脓毒症筛查)及其与新生儿腹部手术中脓毒症的统计学相关性。
在新德里ABVIMS和拉姆·马诺哈尔·洛希亚博士医院的小儿外科,对30例年龄在0至28天之间患有外科急腹症的连续新生儿病例进行了前瞻性观察研究。研究持续时间为18个月。在所有新生儿手术的第0、1、3、7和14天,通过血清降钙素原、C反应蛋白、白细胞总数、未成熟/总中性粒细胞比率和微量红细胞沉降率进行脓毒症筛查。脓毒症筛查呈阳性的患者(五项参数中有三项或更多项呈阳性)与脓毒症进行相关性分析。
最终共纳入30例腹部手术新生儿病例,其中56.7%(=17例)为男性,43.3%(=13例)为女性。最多见的病例是先天性膈疝20%(=6例),其次是肛门直肠畸形16.7%(=5例)。约70%的新生儿脓毒症筛查呈阳性。根据临床或实验室检查结果,50%的新生儿被诊断为患有脓毒症,因此脓毒症筛查的敏感性和特异性分别为93.33%和40%。本研究的总死亡率为30%。
脓毒症筛查是脓毒症的早期标志物,可用于帮助早期发现新生儿外科脓毒症并进行及时干预,从而降低新生儿手术中的死亡率和发病率。