中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
8期
16-17
,共2页
新生儿%化脓性脑膜炎%危险因素%病原菌%抗生素
新生兒%化膿性腦膜炎%危險因素%病原菌%抗生素
신생인%화농성뇌막염%위험인소%병원균%항생소
Neonate%Purulent meningitis%Risk factor%Pathogenic bacteria%Antibiotics
目的 探讨新生儿化脓性脑膜炎的临床特点,并总结诊治体会.方法 回顾性分析2009年1月至2012年7月收治的31例新生儿化脓性脑膜炎患儿的临床资料.结果 新生儿化脓性脑膜炎的危险因素在足月儿主要为围生期窒息,早产儿主要为胎膜早破、羊水污染.临床表现主要为反应差、发热、肌张力改变、纳差、抽搐等.脑脊液呈淡黄色、黄色,清亮或浑浊,白细胞计数(24 ～4000)×106/L,蛋白1048 ～ 5165 mg/L,糖和氯化物降低.血培养阳性11例,脑脊液培养或涂片阳性12例,均以革兰阳性球菌为主,其中多重耐药的葡萄球菌检出率较高,对万古霉素、克林霉素敏感.结论 新生儿化脓性脑膜炎临床症状不典型,对合并危险因素的患儿应早期行脑脊液检查,并针对病原菌及药敏实验合理选择抗生素治疗.
目的 探討新生兒化膿性腦膜炎的臨床特點,併總結診治體會.方法 迴顧性分析2009年1月至2012年7月收治的31例新生兒化膿性腦膜炎患兒的臨床資料.結果 新生兒化膿性腦膜炎的危險因素在足月兒主要為圍生期窒息,早產兒主要為胎膜早破、羊水汙染.臨床錶現主要為反應差、髮熱、肌張力改變、納差、抽搐等.腦脊液呈淡黃色、黃色,清亮或渾濁,白細胞計數(24 ～4000)×106/L,蛋白1048 ～ 5165 mg/L,糖和氯化物降低.血培養暘性11例,腦脊液培養或塗片暘性12例,均以革蘭暘性毬菌為主,其中多重耐藥的葡萄毬菌檢齣率較高,對萬古黴素、剋林黴素敏感.結論 新生兒化膿性腦膜炎臨床癥狀不典型,對閤併危險因素的患兒應早期行腦脊液檢查,併針對病原菌及藥敏實驗閤理選擇抗生素治療.
목적 탐토신생인화농성뇌막염적림상특점,병총결진치체회.방법 회고성분석2009년1월지2012년7월수치적31례신생인화농성뇌막염환인적림상자료.결과 신생인화농성뇌막염적위험인소재족월인주요위위생기질식,조산인주요위태막조파、양수오염.림상표현주요위반응차、발열、기장력개변、납차、추휵등.뇌척액정담황색、황색,청량혹혼탁,백세포계수(24 ～4000)×106/L,단백1048 ～ 5165 mg/L,당화록화물강저.혈배양양성11례,뇌척액배양혹도편양성12례,균이혁란양성구균위주,기중다중내약적포도구균검출솔교고,대만고매소、극림매소민감.결론 신생인화농성뇌막염림상증상불전형,대합병위험인소적환인응조기행뇌척액검사,병침대병원균급약민실험합리선택항생소치료.
Objective To investigate the clinical feature of neonatal purulent meningitis and to provide scientific basis for diagnosis and treatment.Methods The clinical data of 31 cases of neonatal purulent meningitis from January 2009 to July 2012 were retrospectively analyzed.Results The risk factors of neonatal purulent meningitis in term infants were mainly perinatal asphyxia,and in preterm infants were mainly premature rupture of membranes,amniotic fluid contamination.Poor response,fever,muscle tension change,anorexia and convulsions were early major clinical features.Cerebrospinal fluid was light yellow,yellow,clear or turbid,of which the white blood cell counted (24-4000) × 106/L,protein 1048-5165 mg/L,glucose and chloride reduced.Blood culture was positive in 11 cases,and cerebrospinal fluid culture or coated tablets were positive in 12 cases,both with gram positive coccus mainly.The detection rate of multiple antibiotic resistance in Staphylococcus aureus was higher,which was sensitive to vancomycin and clindamycin.Conclusions The clinical features of neonatal purulent meningitis are not tipical.So pathogenic bacterium should be detected in neonate with risk factors,and susceptibility test and rational use of antibiotic should be done in borderline case.
