Clinical Study On The Relative Factors Of Early DIC In Neonatal Septicemia

Objective:The aim of the study was to investigate the characteristics of neonatal sepsis and to discuss the relative factors of early DIC in neonatal septicemia. So, those can provide a reference for diagnosis the neonatal sepsis combined with DIC early and improve the prognosis of neonatal sepsis.Methods:A retrospective clinical study was done.100 patients in NICU which diagnosed neonatal sepsis were statistically analyzed in this papers from 2012-1-1-2013-12-31. Based on The ISTH overt DIC scoring system,100 patients were divided into normal coagulation group, non-overt DIC group (the early DIC group) and Overt DIC group (the late DIC group).The aim of the study was to investigate the characteristics of neonatal sepsis. Meanwhile, the clinical manifestations, prognosis and the relative clinical factors were analyzed in different groups.Results:1.The clinical manifestations of neonatal sepsis were lack of specific,in which poor response (69%), refused to milk (53%), temperature anomalies (52%),and jaundice (49%) were higher incidence. There were significant differences in sclerema incidences of the three group (χ2=12.776,P<0.05).It was the highest incidence of sclerema in late DIC group(75%).2.There were the highest proportion of Gram-positive bacteria in 100 cases of sepsis.Gram-positive bacteria was 75%,Gram-negative bacteria was 22%,Fungi was 3%.Staphylococcus epidermidis (35%) and hemolytic staphylococci (10%) were higher proportion in Gram-positive bacteria group,Escherichia coli (8%) and Klebsiella pneumoniae (8%) were higher proportion in Gram-negative bacteria group.3.The common complications of neonatal sepsis were neonatal pneumonia(84%),neonatal jaundice (49%), neonatal hypoxic-ischemic encephalopathy (29%) and neonatal omphalitis (27%) and so on.4.44 case (44%) had the early DIC in the 100 cases of sepsis. The clinical manifestations of premature birth, asphyxia, sclerema, the bleeding, G-bacterial infections, Crp≥10mg/L were positively related to the sepsis combined with the early DIC (P<0.05),in which asphyxia,the bleeding,G- bacterial infections were independent risk factors. there were no correlation between newborn gender, birth weight, abnormal body temperature, WBC count and sepsis patients with early DIC.There were also significant differences in the prognosis of the three groups (χ2=6.578, P<0.05).Conclusion:The clinical symptoms of neonatal sepsis were diversity and poor specificity. Our hospital neonatal pathogenic bacteria were Gram-positive bacteria. There were more complications of neonatal sepsis. Those who had premature birth, asphyxia, scleroderma, bleeding, G bacterial infections, Crp≥10mg/L,especially,those who had asphyxia, bleeding and G- bacterial infections should actively monitor coagulation,and should give early intervention measures to prevent the progress of the early DIC changed to the late DIC,and prevent the occurs of MODS.So, We can reduce the rate of mortality in children with sepsis.