婴幼儿细菌性脑膜炎并发脑积水临床分析  

Clinical analysis of bacterial meningitis with hydrocephalus in infants

作　　者：王迎宾[1] 刘静[1] 马云富[1] 张云鹤[1] 刘金瑜[1] 杨继学 冯孟昭 WANG Yingbin;LIU Jing;MA Yunfu;ZHANG Yunhe;LIU Jinyu;YANG Jixue;FENG Mengzhao(The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2020年第22期2009-2014,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划(编号:LHGJ20190373)。

摘　　要：目的总结57例婴幼儿细菌性脑膜炎并发脑积水的手术治疗体会,分析影响手术疗效的相关危险因素。方法回顾性分析郑州大学第三附属医院2012-07—2018-07确诊为细菌性脑膜炎并发脑积水后行脑室-腹腔分流术的57例患儿的临床资料,分别评估患儿术前、术后随访过程中脑室径/双顶径(V/BP)比值的变化,采用单因素方差分析及多因素Logistic回归分析方法,得出V-P分流术治疗细菌性脑膜炎后脑积水手术疗效的相关危险因素。结果57例患儿中22例治疗无效,35例治疗有效;行脑室-腹腔外引流放置时间12~30 d,平均20 d;通过单因素方差分析及Logistic回归分析发现年龄(OR=5.444,95%CI 1.011~29.332)、分流管堵塞(OR=0.036,95%CI 0.003~0.399)、脑积水严重程度(OR=11.174,95%CI 1.938~64.422)为细菌性脑膜炎并发脑积水行脑室-腹腔分流术预后的危险因素。结论年龄、分流管堵塞、脑积水严重程度为影响预后的危险因素,是否早产、脑室外引流放置时间、性别及穿刺部位与预后无明显相关性。Objective To summarize the experience of surgical treatment of 57 cases of bacterial meningitis complicated with hydrocephalus in infants and analyze the related risk factors that affect the surgical effect.Methods The clinical data of 57 children with bacterial meningitis diagnosed in the Third Affiliated Hospital of Zhengzhou University from July 2012 to July 2018,who underwent ventriculoperitoneal shunt after hydrocephalus,were analyzed retrospectively.The ratio of ventriculoperitoneal diameter to biparietal diameter(V/BP)was evaluated before and during the follow-up.Single factor analysis and multi-factor Logistic regression analysis were used to explore the influence of V-P hand Risk factors related to the effect of surgical treatment.Results Among the 57 cases,22 cases were ineffective and 35 cases were effective.Ventricle-external drainage was placed for 12-30 days,with an average of 20 days.Ventriculoperitoneal extraperitoneal age(OR=5.444,95%CI 1.011-29.332),shunt obstruction(OR=0.036,95%CI 0.003-0.399),and hydrocephalus severity(OR=11.174,95%CI 1.938-64.422)were the risk factors for the prognosis of bacterial meningitis complicated with hydrocephalus.Conclusion Age,obstruction of shunt and severity of hydrocephalus are the risk factors for prognosis.There is no significant correlation between preterm delivery,time of extraventricular drainage,gender and location of puncture and prognosis.

关 键 词：细菌性脑膜炎 脑积水 婴幼儿 脑室-腹腔分流术 

分 类 号：R742.7[医药卫生—神经病学与精神病学]