CAJ | 학술논문

目的：探讨新生儿不同病原菌化脓性脑膜炎的临床特征。方法回顾性分析2011年1月1日至2012年12月31日172例新生儿化脓性脑膜炎患儿的临床资料。结果脑脊液外观浑浊和脓性54例(31.4%)；脑脊液培养阳性70例(40.7%)，以大肠埃希菌、葡萄球菌为主；并发症31例(18.0%)，其中脑积水14例(8.1%)。大肠埃希菌脑膜炎组与其他病原菌组、不明病原菌组比较，脑脊液外观异常比例、脑脊液白细胞计数、脑脊液白细胞计数>500×106/L比例、脑脊液糖和蛋白水平、发热持续时间、脑脊液恢复正常时间、住院时间和费用、并发症和死亡的比例差异有统计学意义(P均<0.05)。结论对于脑脊液外观呈浑浊和脓性，尤其脑脊液白细胞数>500×106/L时，需重点考虑大肠埃希菌感染可能，其并发症多、病死率高，预后相对较差。
목적：탐토신생인불동병원균화농성뇌막염적림상특정。방법회고성분석2011년1월1일지2012년12월31일172례신생인화농성뇌막염환인적림상자료。결과뇌척액외관혼탁화농성54례(31.4%)；뇌척액배양양성70례(40.7%)，이대장애희균、포도구균위주；병발증31례(18.0%)，기중뇌적수14례(8.1%)。대장애희균뇌막염조여기타병원균조、불명병원균조비교，뇌척액외관이상비례、뇌척액백세포계수、뇌척액백세포계수>500×106/L비례、뇌척액당화단백수평、발열지속시간、뇌척액회복정상시간、주원시간화비용、병발증화사망적비례차이유통계학의의(P균<0.05)。결론대우뇌척액외관정혼탁화농성，우기뇌척액백세포수>500×106/L시，수중점고필대장애희균감염가능，기병발증다、병사솔고，예후상대교차。
Objective To explore the clinical characteristics of purulent meningitis caused by different pathogens in neonates. Methods Clinical data of 172 cases of neonatal purulent meningitis from January 1, 2011 to December 31, 2012 were retrospectively analyzed. Results Cerebrospinal lfuid (CSF) appeared turbid and purulent in 54 cases (31.4%). The CSF cultures showed positive in 70 cases (40.7%), and Escherichia coli (E. coli) and staphylococcus were common. Thirty-one patients had complications (18.0%), among whom, 14 patients (8.1%) were complicated by hydrocephalus. Among E. coli meningitis group, other pathogens group and unknown pathogens group, there were signiifcant differences in the rate of abnormal CSF appearance, CSF white blood cell counts, the rate of CSF white blood cell counts greater than 500×106/L, the levels of sugar and protein in CSF, duration of fever, the time of CSF return to normal, length of hospital stay and cost, complication and case-fatality rate (all P<0.05). Conclusions When CSF appears turbid and purulent, especially when CSF white blood cell counts are greater than 500×106/L, E. coli infection should be considered. The purulent meningitis caused by E. coli has high occurrence rates of compli-cation and case-fatality and poor prognosis.