新生儿化脓性脑膜炎预后不良危险因素分析  

Analysis of Risk Factors for Adverse Outcomes of Neonatal Purulent Meningitis

作　　者：杨慧[1] 魏雪梅[1] 林素芳[1] 黄惠君[1] 付雪梅[1] 

机构地区：[1]深圳市儿童医院,广东深圳518000

出　　处：《儿科药学杂志》2015年第5期13-16,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨影响新生儿化脓性脑膜炎预后不良的危险因素。方法:对2011年1月至2014年1月深圳市儿童医院新生儿科诊断为化脓性脑膜炎的73例患儿进行回顾性分析,根据临床预后分为预后良好组与预后不良组,比较两组患儿病史、临床表现、并发症、辅助检查、治疗等。结果:预后良好组50例,预后不良组23例。预后良好组和预后不良组脑脊液蛋白中位数(P50)分别为2 116 mg/L、3 065 mg/L,脑脊液糖P50分别为1.36 mmol/L、1.00 mmol/L,脑脊液乳酸脱氢酶P50分别为70.0 U/L、127.0 U/L,两组比较差异均有统计学意义(P均<0.05);两组抽搐、前囟改变、意识改变、瞳孔改变的例数分别为16例、14例、13例、18例和14例,14例、13例、16例,差异有统计学意义(P均<0.05);两组患儿年龄、住院时间、入院时体质量、入院时间、体温和外周血白细胞、降钙素原、CRP、外周血血红蛋白水平以及代谢性酸中毒、低钠血症、低蛋白血症、血小板减少、黄疸、呼吸道症状、消化道症状、肌张力、原始反射、病原学检测、是否使用激素等例数比较差异均无统计学意义(P均>0.05)。结论:影响新生儿化脓性脑膜炎不良预后的危险因素主要是意识水平降低、抽搐、前囟张力高、瞳孔对光反射不灵敏或瞳孔不等大等圆;预后不良的患儿在脑脊液的常规检查及生化检查中异常的更为明显。Objective： To investigate the risk factors for poor prognosis of neonatal purulent meningitis. Methods： Seventy-three cases which were diagnosed neonatal purulent meningitis in NICU of Shenzhen Children＇ s Hospital from January 2011 to January 2014 were retrospective analyzed. They were divided into the eusemia group and the poor prognosis group according to the clinical outcomes. The history, clinical manifestation, auxiliary examination, treatment, complications were analyzed. Results： There were 50 cases in favorable prognosis group and 23 eases in poor prognosis group. In prognosis group and poor prognosis group of cerebrospinal fluid, the protein P50 were 2,116 mg/L and 3,056 mg/L, the sugar were 1.36 mmol/L and 1.00 mmol/L, lactate dehydrogenase were 127.0 U/L and 70.0 U/L. Convulsion, the change of former fontanelle, change of consciousness, the change of pupil were 16 cases, 14 cases, 13 eases, 18 cases and 14 cases, 14 cases, 13 cases, 16 cases. Which were statistically significant difference between the two groups （P〈0.05）. The age, length of hospital stay, weight, admission to hospital time, body temperature, peripheral blood leukocyte, calcitonin, CRP, hemoglobin, metabolic acidosis, hyponatremia, hypoalbuminemia, thrombocytopenia, jaundice, respiratory performance, digestive performance, muscle tension, primitive reflex, etiology test, whether to use hormones, etc. were not statistically significant difference between the two groups （ P〉0.05 ）. Conclusion： The dangerous factors affecting neonatal purulent meningitis poor prognosis are consciousness levels drop, convulsion, the high tension of fontanelle, the change of light reflex, children of poor prognosis in biochemical examination of cerebrospinal fluid anomaly is more apparent.

关 键 词：新生儿 化脓性脑膜炎 预后不良 危险因素 

分 类 号：R725.1[医药卫生—儿科]