儿童细菌性脑膜炎的后遗症及其危险因素研究进展  

Study progress of sequelaes and risk factors of bacterial meningitis in children

作　　者：张金晶[1] 王亚娟[1] 

机构地区：[1]首都医科大学附属北京儿童医院新生儿中心,100045

出　　处：《中华实用儿科临床杂志》2013年第12期939-942,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：首都医学发展科研基金项目（2009-2078）;北京市卫生系统高层次卫生技术人才培养计划（2009-3-41）

摘　　要：儿童细菌性脑膜炎仍是导致儿童死亡的重要原因，而细菌性脑膜炎所致后遗症也并不少见，细菌性脑膜炎患者出院后至少发生1种后遗症的平均概率为19．9％，包括听力障碍、认知障碍、运动障碍、癫痫、视力障碍等，其中听力障碍是最常见的后遗症，多种后遗症可同时存在。入院时患儿的意识水平、惊厥、起病时间〉48h、外周循环衰竭、致病菌为肺炎链球菌是细菌性脑膜炎发生后遗症的公认危险因素。外周血白细胞计数、脑脊液糖及蛋白水平亦与细菌性脑膜炎预后密切相关。入院时低钠血症提示预后不良。男童及激素的应用对细菌性脑膜炎后遗症影响尚无定论。Bacterial meningitis in children is still a life-threatening disease which causes a serious of seque- laes, the median risk of at least 1 major or minor sequelae after hospital discharge is 19.9% ,including hearing impair- ment, cognitive impairment, motor disorders, seizures, visual impairment and so on. Of all these sequelaes, hearing im- pairment is the most common type. Multiple sequelae is recognized. Prognostic factors are found to be statistically signi- ficant： coma/impaired consciousness, complaints 〉 48 hours before admission, seizures at admission, peripheral circula- tory failure, respiratory distress, Streptococcus pneumonia as causative pathogen were recognized as the risk factors for sequeales. And cerebrospinal fluid parameters and white blood cell count were closely related to sequelaes. Hypokalie- mia at admission also indicate poor prognosis, but need independent validation in clinical works. Male gender and cor- ticoids were still in discussion.

关 键 词：细菌性脑膜炎 后遗症 危险因素 儿童 

分 类 号：R725.1[医药卫生—儿科]