化脓性脑膜炎患儿感染后遗症预后危险因素研究  

Risk factors of sequelae prognosis in children with purulent meningitis infection

作　　者：王秀锋[1] 孙瑞雪[1] 付琳 王芳[1] 张艳玲[1] 

机构地区：[1]河北医科大学附属邢台市人民医院儿三科,河北邢台054000 [2]河北医科大学附属邢台市人民医院病理科,河北邢台054000

出　　处：《中华医院感染学杂志》2016年第20期4743-4745,共3页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅医学科研基金资助项目(20134507);河北省邢台市科技计划支撑基金资助项目(2015ZC081)

摘　　要：目的探讨儿童化脓性脑膜炎合并感染后遗症临床预后危险因素,为临床提供依据。方法选取2014年9月-2015年10月医院诊治148例儿童化脓性脑膜炎合并感染后遗症患儿资料进行分析,将患儿根据预后分为对照组和试验组,对照组30例患儿预后不良,试验组118例患儿预后良好,采用自拟问卷调查表对两组患儿相关资料等进行单因素和多因素非条件logistic分析。结果试验组患儿脑脊液蛋白含量、血清降钙素原(PCT),显著低于对照组(P<0.05);试验组脑积液糖浓度、血小板计数,显著高于对照组(P<0.05);单因素结果显示,儿童化脓性脑膜炎合并感染后遗症临床预后不良反应与抽搐、昏迷(Glasgow评分<8分)、脑膜刺激征、反复呕吐≥3次,差异无统计学意义,与瞳孔不等大、脑脊液糖≤1.5mmol/L、肢体活动障碍以及住院时间>21d关系密切,差异有统计学意义(P<0.05);多因素logistic结果显示,儿童化脓性脑膜炎合并感染后遗症的临床预后不良与患儿瞳孔不等大、脑脊液糖≤1.5 mmol/L、脑脊液蛋白>1 000 mg/L及住院时间>21d关系密切(P<0.05)。结论儿童化脓性脑膜炎合并感染后遗症患儿后遗症影响因素相对较多,应该根据危险因素提出针对性的措施,提高临床预后。OBJECTIVE To investigate the risk factors of sequelae prognosis in children with purulent meningitis combined infection, so as to provide a basis for clinical practicel METHODS A total of 148 cases of children＇s clini- cal data with purulent meningitis combined infection sequelae from Sep. 2014 to Oct. 2015 in our hospital were se- lected and analyzed, according to the prognosis the children were divided into control and experimental groups. The control group had 30 cases of children with poor prognosis, and the test group had 118 cases of children with good prognosis, using self questionnaire to two groups of children to give univariate and multivariate unconditional logistic regression analysis. RESULTS The test group of cerebrospinal fluid protein content, procalcitomin was sig- nificantly lower than the control group （P〈0.05）. Cerebrospinal fluid glucose concentration, platelet count was significantly higher than the control group （P〈 0. 05）. Single factor analysis showed that the clinical adverse effects convulsions, coma （Glasgow score 〈 8）, meningeal irritation and repeated vomiting more than 3 times had no significant difference with children with purulent meningitis complicated with infection sequela, but anisocoria, cerebrospinal fluid glucoseS1.5 mmol/L, limb movement disorder and hospitalization time 〉21 days had close relation with the sequela（P〈0. 05）. Multi-factor logistic results showed that anisocoria, cerebrospinal fluid glu- cose≤l. 5 mmol/L, cerebrospinal fluid protein〉1 000 mg/L and hospitalization time 〉21 days had close relation to children with purulent meningitis complicated with infection sequela bad prognosis（P〈0.05）. CONCLUSION Children purulent meningitis combined infection sequelae has many relatively impact factors, which should propose specific measures based on risk factors to improve clinical outcomes.

关 键 词：儿童化脓性脑膜炎 感染后遗症 预后不良 危险因素 

分 类 号：R748[医药卫生—神经病学与精神病学]