不同情况新生儿细菌性脑膜炎的住院情况及近期预后分析  

An analysis of the hospitalizations and short-term prognosis of neonatal bacterial meningitis with different situations

作　　者：颜慧恒[1] 李晖[2] 王艳丽[1] 张永[1] YAN Hui-heng;LI Hui;WANG Yan-li;ZHANG Yong(Department of Neonatology,Guangdong Women and Children Hospital,Guangzhou 511400,Guangdong,China)

机构地区：[1]广东省妇幼保健院新生儿科,广东广州511400 [2]广东省妇幼保健院信息科,广东广州511400

出　　处：《广东医学》2018年第24期3635-3639,共5页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2015A020210063);广州市科技计划项目(编号:201804010370)

摘　　要：目的了解不同胎龄、不同发病时间的新生儿细菌性脑膜炎患儿的住院情况及近期预后。方法选取90例新生儿细菌性脑膜炎作为研究对象,按照不同胎龄、不同发病时间进行分组,通过比较新生儿神经行为测定(NBNA)评分、听力筛查、头颅CT、头颅MRI、振幅整合脑电图等来评估患儿的近期预后。结果 (1)将90例细菌性脑膜炎患儿按胎龄分为早产组(41例)和足月组(49例),早产组男性28例(68. 29%),足月组男性23例(46. 94%),两组性别差异有统计学意义(P=0. 042)。早产组发病日龄为16. 0(6. 5,31. 0) d,足月组发病日龄为7. 0(1. 5,12. 0) d,差异有统计学意义(P <0. 001)。早产组住院总时长(53. 41±28. 50) d,足月组住院总时长(25. 53±13. 27) d,两组差异有统计学意义(P <0. 001)。早产组NBNA评分异常比例为57. 14%,足月组NBNA评分异常比例为81. 82%,差异有统计学意义(P <0. 05)。早产组治愈出院共33例,未愈出院共7例,死亡1例,足月组治愈出院共28例,未愈出院共16例,死亡4例,两组出院时情况的差异有统计学意义(P <0. 05)。(2)将90例细菌性脑膜炎患儿按发病时间不同分为早发组(23例)和晚发组(67例),早发组NBNA异常比例占89. 47%,晚发组NBNA异常比例占61. 90%,两组差异有统计学意义(P <0. 001)。两组病例在胎龄构成、住院总时长、平均日住院费用、头颅MRI/CT异常比例、振幅整合脑电图(a EEG)异常比例、听力筛查异常比例、出院时情况的比较上,差异均无统计学意义(P> 0. 05)。结论在细菌性脑膜炎患儿中,与足月儿相比,早产患儿男性病例更多,细菌性脑膜炎发病日龄更晚,住院总时间更长,NBNA评分异常比例较低,出院时治愈出院比例更高,死亡比例更低。早发感染的病例与晚发感染的病例相比较,早发组NBNA评分异常比例较晚发组高。Objective To analyze the hospitalization and short-term prognosis of neonatal bacterial meningitis in infants with different gestational ages and different onsets. Methods Ninety neonates with bacterial meningitis were retrospectively analyzed. According to different gestational ages and times of onset they were divided into 2 groups. The length of hospitalization,cost of hospitalization,duration of antibiotic,NBNA scores,hearing screening results,cranial CT or MRI results,amplitude integrated EEG,outcomes of discharge hospital were compared. Results( 1) Ninety patients diagnosed with bacterial meningitis were divided into preterm group( Group 1,n = 41) and term group( Group 2,n = 49). There were 68. 29% males in Group 1,while 46. 94% in Group 2,with significant difference between them( P = 0. 042). The time of onset of bacterial meningitis of Group 1 was significantly later than that of Group 2 [16. 0( 6. 5,31. 0) d vs. 7. 0( 1. 5,12. 0) d,P < 0. 001]. The length of hospitalization of Group 1 was significantly longer than that of Group 2 [( 53. 41 ± 28. 50) d vs.( 25. 53 ± 13. 27) d,P < 0. 001]. The radio of NBNA score abnormalities of Group 1was significantly lower than that of Group 2( 57. 14% vs 81. 82%,P = 0. 035). There were 33 cured and 1 death in Group 1,while 28 cured and 4 deaths in Group 2,the difference was statistically significant( P < 0. 017).( 2) Ninety patients diagnosed with bacterial meningitis were divided into early-onset group( n = 23) and late-onset group( n =67). The radio of NBNA score abnormalities of early-onset group was significantly higher than that of late-onset group( 89. 47% vs. 61. 90%,P < 0. 001). There was no statistically significant difference in gestational age,length of hospitalization,the average daily cost of hospitalization,the ratio of cranial CT or MRI abnormalities,a EEG abnormalities,optoacoustic emissions screening,auditory evoked potential screening or status on leaving hospital between the two groups.Conclusion Compared with term infant,the preterm infant with b

关 键 词：细菌性脑膜炎 新生儿 近期预后 

分 类 号：R722.1[医药卫生—儿科]