中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2014年
10期
754-757
,共4页
张赟%丁明杰%韩玉玲%马香
張赟%丁明傑%韓玉玲%馬香
장빈%정명걸%한옥령%마향
肺炎链球菌脑膜炎%临床特征%耐药性%儿童
肺炎鏈毬菌腦膜炎%臨床特徵%耐藥性%兒童
폐염련구균뇌막염%림상특정%내약성%인동
Streptococcus pneumoniae meningitis%Clinical characteristic%Antimicrobial resistance%Child
目的 探讨儿章肺炎链球菌脑膜炎的临床特征、并发症、耐药性资料及预后,以提高对该病的诊疗水平.方法 回顾性分析2010年1月至2013年1月在山东大学齐鲁儿童医院确诊为肺炎链球菌脑膜炎的15例住院患儿的临床资料及细菌培养等检测结果,并对患儿随访0.5年以了解预后.结果 15例患儿中11例发生于冬、春季,以2岁以下婴幼儿多见(占13例),忠儿均来自农村;临床表现多样,症状严重,体征及腑脊液改变明显,并发症和后遗症多,部分重症或死亡患儿体温不升,且有白细胞或血小板降低;贫血(10例)、低蛋白血症(9例)、脓毒症(8例)为肺炎链球菌脑膜炎忠儿常见的并发症;多重耐药及并发症出现是治疗困难的主要原因;15例患儿中痊愈3例,9例患儿遗留语言、运动、脑积水、认知功能障碍,死亡3例,多脏器功能障碍综合征是肺炎链球菌脑膜炎患儿死亡的主要原因.结论 肺炎链球菌脑膜炎好发于2岁以下居住于农村的婴幼儿,临床表现及脑脊液改变明显;重症患儿可表现为体温不升,且白细胞或血小板降低,并发症和后遗症多;多重耐药及并发症山现是治疗困难的主要原因.
目的 探討兒章肺炎鏈毬菌腦膜炎的臨床特徵、併髮癥、耐藥性資料及預後,以提高對該病的診療水平.方法 迴顧性分析2010年1月至2013年1月在山東大學齊魯兒童醫院確診為肺炎鏈毬菌腦膜炎的15例住院患兒的臨床資料及細菌培養等檢測結果,併對患兒隨訪0.5年以瞭解預後.結果 15例患兒中11例髮生于鼕、春季,以2歲以下嬰幼兒多見(佔13例),忠兒均來自農村;臨床錶現多樣,癥狀嚴重,體徵及腑脊液改變明顯,併髮癥和後遺癥多,部分重癥或死亡患兒體溫不升,且有白細胞或血小闆降低;貧血(10例)、低蛋白血癥(9例)、膿毒癥(8例)為肺炎鏈毬菌腦膜炎忠兒常見的併髮癥;多重耐藥及併髮癥齣現是治療睏難的主要原因;15例患兒中痊愈3例,9例患兒遺留語言、運動、腦積水、認知功能障礙,死亡3例,多髒器功能障礙綜閤徵是肺炎鏈毬菌腦膜炎患兒死亡的主要原因.結論 肺炎鏈毬菌腦膜炎好髮于2歲以下居住于農村的嬰幼兒,臨床錶現及腦脊液改變明顯;重癥患兒可錶現為體溫不升,且白細胞或血小闆降低,併髮癥和後遺癥多;多重耐藥及併髮癥山現是治療睏難的主要原因.
목적 탐토인장폐염련구균뇌막염적림상특정、병발증、내약성자료급예후,이제고대해병적진료수평.방법 회고성분석2010년1월지2013년1월재산동대학제로인동의원학진위폐염련구균뇌막염적15례주원환인적림상자료급세균배양등검측결과,병대환인수방0.5년이료해예후.결과 15례환인중11례발생우동、춘계,이2세이하영유인다견(점13례),충인균래자농촌;림상표현다양,증상엄중,체정급부척액개변명현,병발증화후유증다,부분중증혹사망환인체온불승,차유백세포혹혈소판강저;빈혈(10례)、저단백혈증(9례)、농독증(8례)위폐염련구균뇌막염충인상견적병발증;다중내약급병발증출현시치료곤난적주요원인;15례환인중전유3례,9례환인유류어언、운동、뇌적수、인지공능장애,사망3례,다장기공능장애종합정시폐염련구균뇌막염환인사망적주요원인.결론 폐염련구균뇌막염호발우2세이하거주우농촌적영유인,림상표현급뇌척액개변명현;중증환인가표현위체온불승,차백세포혹혈소판강저,병발증화후유증다;다중내약급병발증산현시치료곤난적주요원인.
Objective To summmrize the clinical characteristics complications,antimicrobial resistance and prognosis in 15 children with streptococcus pneumoniae meningitis so as to improve the diagnosis and treatment of this disease.Methods A systematic retrospective analysis was carried out in the Qilu Children's Hospital of Shandong University from Jan.2010 to Jan.2013,and clinical data from 15 children with streptococcus pneumococcal meningitis were retrospectively analyzed and followed up for 6 months in order to observe the prognosis.Results Eleven cases of streptococcus pneumoniae meningitis occuned in the winter and spring.And it often occuned in children less than 2 years of age who lived in rural areas (13 cases).The clinical manifestations showed diverse characteristics,severe symptoms,obvious changes in symptoms and cerebrospinal fluid were observed.Severe or death cases had low temperature,low leukopenia or low blood platelet.Common complications of streptococcus pneumoniae meningitis included anemia (10 cases),hypoalbuminemia (9 cases),sepsis (8 cases).Multi-drug resistance and complications in streptococcus pneumoniae meningitis led to the therapeutic difficulties.In this study,3 cases were cured,9 cases had varying degrees of sequences,such as left languages,sports,hydrocephalus and cognitive dysfunction,and 3 cases died,and the main cause of death was multiple organ dysfunction syndrome.Conclusions Streptococcus pneumoniae meningitis mainly occurred in the winter and spring.And the children under 2 years of age who lives in rural areas were often attacked.Clinical characteristics and cerebrospinal fluid changes obviously; severe cases are common with low temperature,low leukopenia or blood platelet.And there aye often diverse complications and multi-sequelae; the problem of multi-drug resistant and complications can lead to great difficulties in the clinical treatment.
