摘要
目的探讨新生儿重症化脓性脑膜炎的临床特征。方法回顾性选取2014年1月至2017年12月本院新生儿疾病诊治中心诊断的169例化脓性脑膜炎患儿为研究对象,依据病情轻重分为重症组及普通组,收集所有患儿临床资料并统计分析,总结重症化脓性脑膜炎的特征。结果169例患儿中,重症组43例(25.4%),普通组126例(74.6%);重症组治愈21例,存在并发症10例,放弃治疗死亡9例,临床死亡3例;普通组治愈98例,存在并发症17例,自动出院11例,随访2例死亡。重症组与普通组呼吸衰竭、惊厥、意识障碍、血C-反应蛋白水平、脑脊液培养阳性、振幅整合脑电图重度异常、脑脊液/血清糖比值、影像学脑实质异常及并发症发生率、病死率的差异均有统计学意义(P均<0.05)。结论重症化脓性脑膜炎不仅具有脑膜炎表现,还存在脑实质受损和(或)脑功能衰竭的临床特征,病情危重、病死率高、并发症多,对此类患儿应加强管理、及早识别、精准诊治,以期改善预后。
Objective To investigate the clinical characteristics of severe purulent meningitis in neonates.Methods A retrospective study was conducted.One hundred and sixty-nine newborns with purulent meningitis diagnosed at the neonatal center of our hospital from January 2014 to December 2017 were selected.According to the severity of the disease,the cases were divided into severe group and mild group.The clinical data of all children were collected and analyzed,and the characteristics of severe purulent meningitis were summarized.Results Among 169 cases of neonatal purulent meningitis,43 cases(25.4%)were in severe group,and 126 cases(74.6%)were in mild group.Twenty-one cases were cured in severe group,10 cases had complications,9 cases abandoned and 3 cases died.Ninty-eight cases were cured in the mild group,17 cases had complications and 11 cases were discharged automatically and 2 cases died.There were significant differences in respiratory failure requiring mechanical ventilation,convulsion,consciousness disorder,blood C-reactive protein,positive cerebrospinal fluid culture,severe abnormality of amplitude integrated electroencephalogram,cerebrospinal fluid/serum glucose ratio,the incidence rate of complications and mortality between two groups(P<0.05).Conclusion Severe purulent meningitis not only has the manifestation of mild meningitis,but also often has the clinical characteristics of brain parenchymal damage and/or brain failure with more complications and higher mortality.
作者
许邦礼
康文清
Xu Bangli;Kang Wenqing(Neonatal Center,Henan Children′s Hospital and Children′s Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
出处
《中国小儿急救医学》
CAS
2021年第4期312-315,共4页
Chinese Pediatric Emergency Medicine
关键词
婴儿
新生
脑膜炎
细菌性
高危因素
特征
Infant,neonatal
Meningitis,bacterial
High risk factor
Characteristics
