目的 分析新生儿无乳链球菌（B族链球菌,GBS）败血症的临床特点、围产期高危因素及预后,提高临床对GBS败血症的认识。方法 选择21例GBS败血症新生儿（收集病例时间为2018年2月—2021年11月）,采用回顾性调查法分析临床资料;对新生儿临床资料、实验室检查、影像学资料进行统计和对比,分析临床特征,同时比较患儿合并症情况及评估治疗预后结果等。结果 GBS败血症新生儿中早发型（90.48%）明显高于迟发型（9.52%）,P<0.05;GBS败血症新生儿主要症状表现为发热、发绀、气促、呻吟、抽搐等,以气促、呻吟为主;通过实验室检查,发现患儿普遍存在C反应蛋白、降钙素原、白细胞计数等指标异常情况;经头颅MRI检查提示蛛网膜下腔出血6例;X线提示新生儿吸入性综合征6例、双肺新生儿肺炎4例;部分患儿存在合并症,其中1例合并脑膜炎、3例合并蛛网膜下腔出血、4例合并黄疸、2例合并新生儿低血糖;所有患儿接受抗菌药物治疗,以青霉素、头孢他啶为主,平均住院时间（14.86±2.33）d,治愈19例（占比90.48%）、1例患儿好转后家属要求签字出院,1例家属要求转上级儿童医院。结论 新生儿无乳链球菌败血症有早发型和迟发型之分,两者的临床表现及特征有明显差异,该病病情较凶险,临床需高度重视本病的防治工作,早期诊断及时治疗干预,以提高新生儿预后。

Objective To analyze the clinical characteristics,perinatal high-risk factors and prognosis of neonatal Streptococcus agalactiae（group B Streptococcus,GBS）sepsis,and to improve the clinical understanding of Streptococcus agalactiae sepsis．Methods Twenty-one newborns with GES sepsis were selected（the cases were collected from February 2018 to November 2021）,and the clinical data were analyzed by retrospective investigation．The clinical data,laboratory examination and imaging data of newborns were summarized and compared,and the clinical characteristics were analyzed．At the same time,the complications of children were compared and the prognosis of treatment was evaluated．Results In newborns with GBS sepsis,the early-onset rate（90.48%）was significantly higher than the late-onset（9.52%）,P < 0.05．The main symptoms of newborns with GBS sepsis were shortness of breath,moaning,fever,cyanosis,convulsions,etc．Through laboratory examination,it was found that there were common abnormalities in C-reactive protein,procalcitonin,leukocyte count and other indicators in children．Transcranial MRI results showed 6 cases with subarachnoid hemorrhage;X-ray showed 6 cases with neonatal aspiration syndrome and 4 cases with both lungs neonatal pneumonia．Some children had complications,including 1 case with meningitis,3 cases with subarachnoid hemorrhage,4 cases with jaundice,and 2 cases with neonatal hypoglycemia．All children were treated with antibiotics,mainly penicillin and ceftazidime．The average hospital stay was（14.86 ± 2.33）days,and 19 cases were cured（accounting for 90.48%）．One case of the child's family member asked to sign and leave the hospital after improvement,and one case of the family member asked to be transferred to a superior children's hospital．Conclusions Neonatal Streptococcus agalactiae sepsis can be divided into early-onset and late-onset type．There are significant differences in clinical manifestations and characteristics between them．The disease is dangerous,clinical attention should be paid to the prevention and treatment of the disease,early diagnosis and timely treatment and intervention,so as to improve the prognosis of newborns．

目的 探讨新生儿高促甲状腺素血症转归与先天性甲状腺功能减低的相关性。方法 选择2014年4月—2015年4月在本院新生儿疾病筛查中心筛查并诊断为高促甲状腺激素血症的患儿120例,期间密切监测甲状腺功能指标变化。结果 将非治疗组所有患儿按照入组该实验后首次抽取静脉血TSH检测水平分为3组:5.5~10.0 mU/L(20例)、10.1~15.0 mU/L(10例)、＞15.0 mU/L (8例)。非治疗组患儿第2次随访结果显示5.5~10.0 mU/L组所有患儿TSH水平<10.0 mU/L;10.1~15.0 mU/L组有1例患儿TSH水平＞10.0 mU/L,FT4水平在正常值上限;＞15.0 mU/L组有3例患儿 TSH水平＞10.0 mU/L,差异有统计学意义(P< 0.05),FT4水平在正常均值左右,差异没有统计学意义(P＞ 0.05),＞15.0 mU/L组3例患儿给予左旋甲状素钠治疗。治疗组有2例患儿分别在治疗15天和23天后出现医源性甲状腺功能亢进,停药和酌减药量后TSH、FT4水平均恢复正常。两组患者随访结束后TSH、TF4均恢复至正常水平。结论 大多数新生儿高促甲状腺素血症会随着年龄的增长恢复正常,而仅仅有少部分患儿会持续出现甲状腺功能异常,应积极随访;新生儿只有当TSH 基础值＞15.00 mU/L时才需要采用左旋甲状素钠替代治疗,并且严格随访甲状腺功能,避免过度治疗。

目的 游泳抚触操对新生儿神经行为及体格发育影响的研究。方法 将76例正常新生儿随机分为观察组(游泳加抚触操)31例,对照组(常规沐浴)45例,两组新生儿分别于出生后第5天、14天、42天对两组新生儿进行新生儿行为神经评分(NBNA),新生儿生后睡眠情况比较,胎便初排,胎便转黄时间比较,新生儿体重,身长比较。结果 两组新生儿神经行为及体格发育各项指标与对照组相比,差异有统计学意义,(P＜0.01)。结论 游泳抚触操对新生儿神经行为及体格发育有促进作用,临床值得推广应用。