小儿化脓性脑膜炎并发惊厥的危险因素  

Risk factors for convulsion with purulent meningitis in children

作　　者：杨志国[1] 张妮[1] 杨保旺[1] 李兴川[1] 王静[1] 王海东[1] 

机构地区：[1]兰州大学第二医院儿童医院小儿重症科,甘肃兰州730030

出　　处：《临床荟萃》2017年第7期602-605,共4页Clinical Focus

摘　　要：目的探讨小儿化脓性脑膜炎并发惊厥的危险因素。方法回顾性分析86例化脓性脑膜炎患儿的临床资料,根据有无惊厥发作将其分为观察组与对照组。收集所有患儿临床特征、脑脊液实验室检查、病原学检查,并进行多因素Logistic回归分析。结果观察组血钠<135mmol/L及脑脊液白细胞计数<1 000×106/L的比例均高于对照组(P<0.05);两组脑脊液蛋白及糖比较差异无统计学意义;两组肺炎链球菌阳性率差异具有统计学意义(P<0.05),而流感嗜血杆菌及其他菌种的阳性率比较差异无统计学意义。患儿年龄低于2岁、意识障碍、肺炎链球菌感染及血钠<135mmol/L均为化脓性脑膜炎患儿并发惊厥发作的危险因素。结论化脓性脑膜炎患儿并发惊厥的发作与患儿年龄低于2岁、意识障碍、肺炎链球菌感染及血钠<135mmol/L等因素有关。Objective To explore the risk factors of purulent meningitis complicated with convulsion. Methods The data of 86 children with purulent meningitis admitted in our department were retrospectively analyzed. The patients were divided into observation group and control group according to the presence of convulsion. Clinical features, cerebrospinal fluid （CSF） laboratory examination and etiology examination were collected, and the multivariable logistic regression analysis was used to evaluate statistical differences. Results Serum sodium （〈135 mmol/L） and cerebrospinal fluid leukocyte count （〈1 000×10^6/L） were significantly higher in observation group than in control group （P〈0.05）; there were no significant difference in the contents of protein or sugar of cerebrospinal fluid between two groups; there were significant differences in Streptococcus pneumoniae positive rate between two groups （P〈0.05）, and there were no significant difference in the positive rate of Haemophilus influenza and other species between two groups. Multivriable logistic regression analysis was performed in children with purulent meningitis suffering from convulsions and showed that children under two years old, consciousness disorder,Streptococcus pneumoniae and serum sodium （〈135 mmol/L） were the risk factors for children with purulent meningitis complicated with convulsion. Conclusion Children with purulent meningitis complicated with convulsion are related with age under two years old, disorder of consciousness, Streptococcus pneumoniae and blood sodium less than 135 mmol/L.

关 键 词：脑膜炎 惊厥 危险因素 

分 类 号：R515.2[医药卫生—内科学]