现代诊断与治疗
現代診斷與治療
현대진단여치료
MODERN DIAGNOSIS AND TREATMENT
2014年
11期
2401-2403
,共3页
洪琳亮%吴斌%黄欢欢%洪舒婷
洪琳亮%吳斌%黃歡歡%洪舒婷
홍림량%오빈%황환환%홍서정
儿童%化脓性脑膜炎%临床特点
兒童%化膿性腦膜炎%臨床特點
인동%화농성뇌막염%림상특점
Children%Purulent meningitis%Clinical features
目的：探讨儿童化脓性脑膜炎的临床特点，为临床诊断与治疗提供科学依据。方法对本院小儿内科2008年9月~2012年9月确诊为化脓性脑膜炎89例住院患儿临床资料进行回顾性分析。结果89例中≤3岁患儿占48.3%，全年散发，春、夏、秋、冬四季发病率无明显差异，多以发热（92.1%）、精神反应差（76.4%）、呕吐（61.8%）为首发症状就诊，65.2%患儿白细胞计数>10×109/L，80.9%患儿中性粒细胞比例>50%，所有患儿脑脊液常规检查白细胞大于10×106/L，≥500×106/L45例（50.6%），出现并发症22例（24.7%），治疗方案以静脉应用第三代头孢为主，抗生素疗程14～60（平均34）d；临床转归：治愈或好转74例（83.1%），未愈11例（12.4%），死亡4例（4.5%）。结论化脓性脑膜炎仍以婴幼儿为主，临床表现多样，不同年龄段表现存在差异，可结合实验室检查分析，总结临床特点，为临床诊治和转归提供参考。
目的：探討兒童化膿性腦膜炎的臨床特點，為臨床診斷與治療提供科學依據。方法對本院小兒內科2008年9月~2012年9月確診為化膿性腦膜炎89例住院患兒臨床資料進行迴顧性分析。結果89例中≤3歲患兒佔48.3%，全年散髮，春、夏、鞦、鼕四季髮病率無明顯差異，多以髮熱（92.1%）、精神反應差（76.4%）、嘔吐（61.8%）為首髮癥狀就診，65.2%患兒白細胞計數>10×109/L，80.9%患兒中性粒細胞比例>50%，所有患兒腦脊液常規檢查白細胞大于10×106/L，≥500×106/L45例（50.6%），齣現併髮癥22例（24.7%），治療方案以靜脈應用第三代頭孢為主，抗生素療程14～60（平均34）d；臨床轉歸：治愈或好轉74例（83.1%），未愈11例（12.4%），死亡4例（4.5%）。結論化膿性腦膜炎仍以嬰幼兒為主，臨床錶現多樣，不同年齡段錶現存在差異，可結閤實驗室檢查分析，總結臨床特點，為臨床診治和轉歸提供參攷。
목적：탐토인동화농성뇌막염적림상특점，위림상진단여치료제공과학의거。방법대본원소인내과2008년9월~2012년9월학진위화농성뇌막염89례주원환인림상자료진행회고성분석。결과89례중≤3세환인점48.3%，전년산발，춘、하、추、동사계발병솔무명현차이，다이발열（92.1%）、정신반응차（76.4%）、구토（61.8%）위수발증상취진，65.2%환인백세포계수>10×109/L，80.9%환인중성립세포비례>50%，소유환인뇌척액상규검사백세포대우10×106/L，≥500×106/L45례（50.6%），출현병발증22례（24.7%），치료방안이정맥응용제삼대두포위주，항생소료정14～60（평균34）d；림상전귀：치유혹호전74례（83.1%），미유11례（12.4%），사망4례（4.5%）。결론화농성뇌막염잉이영유인위주，림상표현다양，불동년령단표현존재차이，가결합실험실검사분석，총결림상특점，위림상진치화전귀제공삼고。
Objective To investigate the clinical characteristics of purulent meningitis to provide scientific basis for diagnosis and treatment.Methods 89 children with purulent meningitis who were admitted to pediatric department in our hospital from September 2008 to September 2012 were retrospective studied. Results There were 48.3% of the patients with younger than three years old; the incidence of purulent meningitis among four seasons(Spring, Summer, Autumn, Win-ter) showed no significant difference. The clinical manifestations of patients mainly were fever (92.1%), lethargy (76.4%) and vomiting (61.8%). White blood cell (WBC) accounts were more than 10×109/L in 65.2% of patients, neutrophils ratio>50% in 80.9% of patients and WBC in CSF ≥500 ×106/L in 50.6% of cases, 22 cases had complications; Intravenous use of third generation cephalosporins is the main therapeutic regimen, course averaged 34 days(14 to 60 days); The cure or improvement rate, not cured rate and mortality were 83.1%,12.4% and 4.5%, respectively. Conclusion Purulent meningitis mostly happens in infantile period with variety of clinical mani-festations. It depends on the age, diagnosis with laboratory examination according to clinical mani-festation, and it provids reference for clinical diagnosis and prognosis.
