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
2015年
19期
1497-1500
,共4页
化脓性脑膜炎%硬膜下积液%儿童%白细胞计数%C反应蛋白%血小板
化膿性腦膜炎%硬膜下積液%兒童%白細胞計數%C反應蛋白%血小闆
화농성뇌막염%경막하적액%인동%백세포계수%C반응단백%혈소판
Purulent meningitis%Subdural effusion%Child%White blood cell count%C-reactive protein%Platelet
目的：探讨化脓性脑膜炎( PM)并硬膜下积液的临床表现和炎症反应指标演变规律。方法收集2009年1月至2013年12月在深圳市儿童医院住院的化脓性脑膜炎162例,合并硬膜下积液者为硬膜下积液组,未合并硬膜下积液者为对照组,对2组临床资料进行分析。应用SPSS 17.0统计学软件进行数据处理。结果49例(30.25%)并硬膜下积液,37例(75.5%)于病程前10 d发生；婴儿期发生率最高,占48.84%(42例)；硬膜下积液组和对照组在发热、抽搐、精神反应、前囟膨隆等临床表现方面差异无统计学意义；入院当日外周血白细胞增高不明显、C反应蛋白增高明显者,更容易发生硬膜下积液(Z=1．74、2.10,P均<0.05)；而血小板普遍增高,累积异常率达93.75%,但2组间差异无统计学意义。入院时患者外周血白细胞计数影响因素众多,包括年龄、脑脊液培养结果以及入院前抗生素的应用,而C反应蛋白值仅受抗生素影响。结论硬膜下积液多发生于婴儿期,多数于病程前10 d出现。入院时测得PM患儿外周血白细胞较低、C反应蛋白明显升高,或病程中C反应蛋白再次升高,需警惕硬膜下积液的发生。血小板增高或许可以作为感染性疾病的临床特点之一。
目的：探討化膿性腦膜炎( PM)併硬膜下積液的臨床錶現和炎癥反應指標縯變規律。方法收集2009年1月至2013年12月在深圳市兒童醫院住院的化膿性腦膜炎162例,閤併硬膜下積液者為硬膜下積液組,未閤併硬膜下積液者為對照組,對2組臨床資料進行分析。應用SPSS 17.0統計學軟件進行數據處理。結果49例(30.25%)併硬膜下積液,37例(75.5%)于病程前10 d髮生；嬰兒期髮生率最高,佔48.84%(42例)；硬膜下積液組和對照組在髮熱、抽搐、精神反應、前囟膨隆等臨床錶現方麵差異無統計學意義；入院噹日外週血白細胞增高不明顯、C反應蛋白增高明顯者,更容易髮生硬膜下積液(Z=1．74、2.10,P均<0.05)；而血小闆普遍增高,纍積異常率達93.75%,但2組間差異無統計學意義。入院時患者外週血白細胞計數影響因素衆多,包括年齡、腦脊液培養結果以及入院前抗生素的應用,而C反應蛋白值僅受抗生素影響。結論硬膜下積液多髮生于嬰兒期,多數于病程前10 d齣現。入院時測得PM患兒外週血白細胞較低、C反應蛋白明顯升高,或病程中C反應蛋白再次升高,需警惕硬膜下積液的髮生。血小闆增高或許可以作為感染性疾病的臨床特點之一。
목적：탐토화농성뇌막염( PM)병경막하적액적림상표현화염증반응지표연변규률。방법수집2009년1월지2013년12월재심수시인동의원주원적화농성뇌막염162례,합병경막하적액자위경막하적액조,미합병경막하적액자위대조조,대2조림상자료진행분석。응용SPSS 17.0통계학연건진행수거처리。결과49례(30.25%)병경막하적액,37례(75.5%)우병정전10 d발생；영인기발생솔최고,점48.84%(42례)；경막하적액조화대조조재발열、추휵、정신반응、전신팽륭등림상표현방면차이무통계학의의；입원당일외주혈백세포증고불명현、C반응단백증고명현자,경용역발생경막하적액(Z=1．74、2.10,P균<0.05)；이혈소판보편증고,루적이상솔체93.75%,단2조간차이무통계학의의。입원시환자외주혈백세포계수영향인소음다,포괄년령、뇌척액배양결과이급입원전항생소적응용,이C반응단백치부수항생소영향。결론경막하적액다발생우영인기,다수우병정전10 d출현。입원시측득PM환인외주혈백세포교저、C반응단백명현승고,혹병정중C반응단백재차승고,수경척경막하적액적발생。혈소판증고혹허가이작위감염성질병적림상특점지일。
Objective To explore the clinical and peripheral blood characteristics of childhood purulent meningitis complicated with subdural effusion. Methods A retrospective cohort chart review was performed. A total of 162 consecutive cases of purulent meningitis were identified in Shenzhen Children′s Hospital from January 2009 to De-cember 2013,all of them were divided into 2 groups according to whether complicating with subdural effusion, and the clinical characteristics of 2 groups were analyzed. The clinical characteristics were analyzed. The statistical data were determined by SPSS 17. 0 software. Results Forty-nine cases(30. 25%)of them were complicated with subdural effu-sion;and 37 cases (75. 5%)of them suffered from the disease in the first 10 days after the onset of the meningitis,and the incidence was 48. 84% (42 cases) in infancy. Fever,lethargy,seizures and bulging fontanelle were its common clinical signs,and there were no significant differences in the incidence between subdural effusion group and the control group(non-subdural effusion group),the white blood cell (WBC) count did not increase markedly and C-reactive pro-tein(CRP) was high in the subdural effusion group on the admission day(Z=1. 74,2. 10,all P<0. 05),but no differ-ence in platelet( PLT) . The PLT was high in the whole meningitis cohort,the ratio of cases whose PLT was higher than 300×109/L reached 93. 75%,but no difference between the 2 groups. There were many factors of WBC on admission, including age, cerebrospinal fluid culture results and the application of antibiotics before admission, but CRP was only affected by antibiotics. Conclusions Subdural effusion is common in infancy,and most occurred in the first 10 days af-ter onset of the meningitis. On admission day the CRP,was high, while WBC did not increase too much. If CRP rises for the second time it might predict the occurrence of subdural effusion in bacterial meningitis. The increased PLT may be considered as clinical feature of infectious diseases. The clinical implication of inflammatory pathophysiology in men-ingitis needs further investigation.
