| 摘要: |
| 目的:探讨新生儿化脓性脑膜炎预后的影响因素。方法:采用回顾性研究方法,分析2010-2014年在重庆医科大学附属儿童医院诊断为新生儿化脓性脑膜炎的151例住院患儿的病历资料,根据转归结果分为预后良好组和预后不良组,比较两组患儿住院期间的临床表现、实验室检查结果、病原学检查结果,分析新生儿化脓性脑膜炎预后不良的相关因素。结果:预后不良组68例,预后良好组83例。预后不良组和预后良好组胎膜早破率(29.4% vs 25.3%)、低出生体质量率(16.2% vs 14.5%) 等围产期情况比较差异均无统计学意义(P均>0.05)。两组患儿主要临床表现为发热、反应差、抽搐等,差异无统计学意义(P均>0.05)。两组超敏C反应蛋白水平等比较差异无统计学意义(P>0.05)。预后不良组与预后良好组的脑脊液葡萄糖含量中位数(1.38 mmol/L vs 2.08 mmol/L)、脑脊液蛋白含量中位数(2.17 g/L vs 1.20 g/L)比较差异均有统计学意义(P均<0.01)。病原学培养检出细菌共84株,其中革兰阴性菌占89.29%(75/84),以大肠埃希菌为主(38株),两组病原菌分布比较差异无统计学意义(P>0.05)。结论:新生儿化脓性脑膜炎预后不良与患儿脑脊液葡萄糖含量降低、蛋白含量升高有关。 |
| 关键词: 化脓性脑膜炎 新生儿 预后 影响因素 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2017.06.004 |
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| 基金项目: |
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| The Influencing Factors Related to the Prognosis of Neonatal Purulent Meningitis with the Analysis of 151 Cases |
| Hua Xueying1 , Zhao Zhi2 , Yu Jialin1 |
| (1. Children's Hospital of Chongqing Medical University, Chongqing 400014, China;2. People' Hospital of Shaanxi Province, Shaanxi Xi'an 710068, China) |
| Abstract: |
| Objective: To explore the influencing factors related to the prognosis of neonatal purulent meningitis. Methods: One hundred and fifty-one neonates who diagnosed with purulent meningitis at the Children's Hospital of Chongqing Medical University from 2010 to 2014, were retrospectively analyzed with the clinical data and divided into good prognosis group and poor prognosis group according to the results of prognosis. Compared the differences of two groups on clinical manifestations, the results of laboratory
examinations and etiology examinations, to analysis the factors related to the poor prognosis of purulent meningitis in neonates. Results: Of 151 cases, 68 cases were poor prognosis while 83 cases were good prognosis. The incidence of premature rupture of membranes (29.4% vs 25.3%), the incidence of LBW (16.2% vs 14.5%), there were no significant differences between the two groups (P>0.05). The main clinical manifestations of the neonatal purulent meningitis were fever, poor response, convulsion and so on, but there was no significant difference between the two groups (P>0.05). The level of high-sensitivity C-reactive protein in two groups had no significant difference (P>0.05). The median of sugar concentration of cerebrospinal fluid (1.38 mmol/L vs 2.08 mmol/L) and the protein of cerebrospinal fluid (2.17 g/L vs 1.20 g/L) in two groups had significant differences (P<0.05). In terms of pathogens, the totality of bacteria is 84 and the main pathogens were gram negative bacteria (89.29%), among them the main bacteria is E.coli (38 strains), but there was no significant difference between the two groups (P>0.05). Conclusion: The poor prognosis of neonatal purulent meningitis is related to low sugar concentration and high protein content of cerebrospinal fluid. |
| Key words: purulent meningitis neonate prognosis influencing factors |
