早产儿和足月儿化脓性脑膜炎临床对比研究  

Clinical comparative study of purulent meningitis between preterm neonates and full-term neonates

作　　者：祝雪英 郁峰[2] ZHU Xue-ying;YU Feng(Department of Pediatrics,Lanxi People＇s Hospital,Zhej iang Lanxi 321100,China;Department of Pediatric Neurology,Huzhou Central Hospital,Zhejiang Huzhou 313003,China)

机构地区：[1]兰溪市人民医院儿科,浙江兰溪321100 [2]湖州市中心医院小儿神经科,浙江湖州313003

出　　处：《中国妇幼健康研究》2018年第7期883-886,共4页Chinese Journal of Woman and Child Health Research

摘　　要：目的对比患化脓性脑膜炎的早产儿和足月新生儿的临床表现,为该病的临床诊疗和预后评估提供理论依据。方法回顾性分析2014年1月到2017年1月期间兰溪市人民医院收治的66例化脓性脑膜炎新生儿的临床资料,对比早产患儿和足月患儿临床表现的构成情况,合并症的发生率、死亡率、致病菌的构成情况,血感染指标、脑脊液检测结果及颅脑MRI的表现情况。结果早产患儿反应差、拒乳、发绀的发生率高于足月患儿,发热的发生率低于足月患儿,差异有统计学意义(χ~2值分别为5.456、7.912、5.967、6.944,均P<0.05)。早产患儿神经系统临床表现发生率25.00%,低于足月患儿(58.70%),差异有统计学意义(χ~2=6.336,P<0.05)。早产患儿合并症发生率35.00%,高于足月患儿(10.87%),差异有统计学意义(χ~2=5.456,P<0.05)。早产患儿大肠埃希菌的感染率为20.00%,高于足月患儿(2.17%),差异有统计学意义(χ~2=6.326,P<0.05)。早产患儿颅内出血的发生率为30.00%,脑室扩张的发生率为15.00%,脑梗死的发生率为5.00%,脑室周围白质软化的发生率为10.00%,颅脑MRI异常率为60.00%,高于足月患儿(30.43%),差异有统计学意义(χ~2=5.103,P<0.05)。结论与足月化脓性脑膜炎患儿相比,早产患儿的临床表现较不典型,且大肠埃希菌的感染率及颅脑MRI的阳性率较高。临床上可根据患儿的临床表现,结合脑脊液检查结果,及早明确诊断,使患儿得到早期治疗。Objective To compare the clinical manifestations of infective purulent meningitis between preterm neonates and full-term neonates,so as to provide theoretical basis for clinical diagnosis and prognosis evaluation of the disease.Methods Clinical data of 66 neonates with infected purulent meningitis admitted to Lanxi People＇s Hospital during January 2014 to January 2017 were analyzed retrospectively.The composition of the clinical manifestations,the incidence of complication,the mortality,the composition of the pathogenic bacteria,the blood infection index,the results of cerebrospinal fluid detection and the performance of brain MRI between preterm neonates and full-term neonates with infected purulent meningitis were compared.Results The incidence of poor response,refusal of breast milk and cyanosis in preterm neonates was higher than that in full-term neonates,while the incidence of fever in preterm neonates was lower than that in full-term neonates.The differences were statistically significant（χ^2 value was5.456,7.912,5.967,and 6.944,respectively,all P〈0.05）.The incidence of clinical manifestations of nervous system in preterm neonates was 25.00%,which was lower than that in full-term neonates（58.70%）,and the difference was statistically significant（χ^2=6.336,P〈0.05）.The incidence of complications in preterm neonates was 35.00%,and it was higher than that in full-term neonates（10.87%）with significant difference（χ^2=5.456,P〈0.05）.The infection rate of Escherichia coli in preterm neonates was 20.00%,which was higher than that in full-term neonates（2.17%）,and the difference was statistically significant（χ^2=6.326,P〈0.05）.In preterm neonates,the incidence of intracranial hemorrhage,ventricular dilatation,cerebral infarction and periventricular white softening was 30.00%,15.00%,5.00% and 10.00%,respectively.Abnormal rate of craniocerebral MRI was60.00%,which was higher than that in the full-term neonates（30.43%）,and the difference was statistically significant（χ^2=5.1

关 键 词：感染 化脓性脑膜炎 早产儿 足月儿 并发症 

分 类 号：R729[医药卫生—儿科]