儿童再发性化脓性脑膜炎33例再发病因分析与随访  

Etiological analysis and follow-up of 33 recurrent purulent meningitis in children

作　　者：陈荷英[1] 张桂芳[1] 李绍英[1] 胡冰[1] 刘钢[1] 

机构地区：[1]首都医科大学附属北京儿童医院内科,100045

出　　处：《北京医学》2011年第6期479-483,共5页Beijing Medical Journal

摘　　要：目的总结儿童再发性化脓性脑膜炎临床特征与再发病因。方法总结我院2006年1月至2010年3月间收治的33例再发性化脓性脑膜炎患儿临床资料,分析其再发病因。结果男22例,女11例,年龄1岁2月至15岁,平均年龄7岁,2岁以上患儿共28例(84.85%)。化脑再发2次24例,3次4例,4次4例,6次1例,共患化脓性脑膜炎82例次。再发化脑病因包括先天性解剖结构异常共25例(75.76%),头面部、脊柱外伤或术后引起再发化脑5例(15.15%);先天免疫缺陷病3例(9.09%)等,各年龄在不同病因分布无差异(P>0.05);其中先天性内耳畸形合并脑脊液耳漏或耳鼻漏11例(33.33%)和皮毛窦10例(30.3%)是主要的解剖结构异常。结论再发化脑多见于2岁以上儿童,先天性解剖结构异常、头面部外伤、手术及免疫功能缺陷是引起化脓性脑膜炎再发的主要因素。Objective To investigate the clinical characteristics and causes of recurrent purulent meningitis.Methods Clinical data of 33 recurrent purulent meningitis cases was analyzed retrospectively,who had been hospitalized in Beijing children＇s hospital from January 2006 to March 2010.Results There were 22 male and 11 female patients involved in this study.The age of these patients arranged from 1year and 2 months old to 15 years old,with the average age of 7 years old.Twenty-eighth patients were older than 2 years old,which accounted for 84.85%（28/33） of all cases.There were 24 patients with 2 episodes,four patients with 3 episodes,four patients with 4 episodes,one patient with 6 episodes,namely 82 episodes in total.Twenty-five（75.76%） patients were caused by congenital abnormal anatomic structure,five（15.15%） of which were caused by trauma in cephalic region or vertebral region or operation;three（9.09%） caused by congenital immunodeficiency and so on.The age distribution of different causes had no significant difference（P〉 0.05）.The major anatomical abnormalities were inner ear congenital malformation combined with cerebrospinal fluid otorrhea or rhinorrhea occurring in 11 patients（33.33%） and dermal sinus in 10 patients（30.30%）.Conclusions Recurrent purulent meningitis occurred mostly in children who were older than 2.The main causes were congenital anatomy abnormalities,trauma or operation of cephalic region and immunodeficiency.

关 键 词：化脓性脑膜炎 再发 病因 儿童 

分 类 号：R725.1[医药卫生—儿科]