新生儿骨髓炎13例临床分析

doi:10.7504/ek2014080610

摘要/Abstract

摘要：

目的探讨新生儿骨髓炎的临床特点。方法对重庆医科大学附属儿童医院2004—2012年诊断为新生儿骨髓炎的13例患儿的临床表现、实验室检查、影像学特征及治疗方案进行回顾性分析。结果本组13例。10例继发于败血症，3例由邻近感染扩散而来；四肢长骨尤其是股骨、肱骨最易受累，6例并发关节感染，最常见受累关节为髋关节、膝关节；最常见临床表现为局部红肿及肢体活动受限（假瘫痪）；血或脓液、关节液培养出致病菌12例，其中金黄色葡萄球菌7例，革兰阴性（G-）杆菌4例；所有患儿均行抗生素治疗， 4例联合手术治疗，随访7例均无后遗症发生。结论新生儿骨髓炎并不罕见，临床表现不典型，应尽早完善影像学和病原学检查，早期使用足量敏感抗生素和必要时联合手术治疗可减少后遗症的发生。

关键词: 骨髓炎, 新生儿, 诊断, 治疗

Abstract:

Abstract：Objective To expore the clinical features of acute osteomyelitis of neonate. Methods A retrospective study was done about clinical symptoms，radiologic features and treatments in 13 neonates who were diagnosed with osteomyelitis in Children’s Hospital Affliated to Chongqing University of Medical Sciences from 2004 to 2012. Results There were eleven male and two female infants；10 babies were related to bacteraemia and 3 cases were due to infection nearby.Limb bones were most commonly compromised. Six babies had joint involvement. Local swelling and disorder of limb’s activity were the most common clinical symptoms. Twelve patients got positve culture results from blood，pus or joint fluid samples. The most common pathogens were Staphylococcus aureus and Gram-negative bacteria. All of the babies accepted antibiotic treatment while 4 cases also underwent surgeries. All osteomyelitis patients had good outcomes. None had any sequelae among the 7 cases during the following 2 months to 2 years. Conclusion Neonatal osteomyelitis is not a rare disease with atypical clinical features. Radiologic and bacteriologic examination should be carried out once osteomyelitis is suspected. Appropriate antibiotics and necessary surgery are important to avoid further damage as well as long-term sequelae.

Key words: osteomyelitis, neonate, diagnosis, treatment

中图分类号:

Ｒ72

赵奇思，韦红，华子瑜，陈贻骥，余加林. 新生儿骨髓炎13例临床分析[J]. 中国实用儿科杂志, DOI: 10.7504/ek2014080610.

ZHAO Qi-si，WEI Hong，HUA Zi-yu，CHEN Yi-ji，YU Jia-lin.. Clinical analysis of neonatal acute osteomyelitis in 13 cases.[J]. Acta Metallurgica Sinica, DOI: 10.7504/ek2014080610.

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