新生儿化脓性脑炎早期诊治临床分析(附18例)

Clinical Analysis of Diagnosis and Treatment of Early Stage of the Neonatal Purulent Meningitis(18 Cases)

目的探讨新生儿化脓性脑膜炎的早期临床特点和干预措施。方法选择2010年1月至2011年12月新生儿科收治的化脓性脑膜炎患儿18例进行回顾性分析。结果新生儿化脓性脑膜炎在发病初期多有体温异常(发热或体温不升),哭声弱或呻吟,呼吸暂停,肌张力改变,前囟紧张或饱满等,血白细胞总数未见明显异常现象,CRP增高占72.2%,脑脊液白细胞和蛋白均增高,葡萄糖≥2.2mmol/L3例占16.79%,病原菌主要是葡萄球菌,大肠埃希菌。结论新生儿化脓性脑膜炎在发病早期临床表现不典型,尽早行脑脊液检查,及时合理应用抗生素是治疗关键。

Objective To explore the clinical characteristics of early stage of the neonatal purulent meningitis and the intervention measures. Methods Eighteen cases of newborn purulent meningitis in our department from January 2010 to December 2011 were retrospectively analyzed. Results The most common clinical manifestations of neonatal purulent meningitis were abnormalities of body temperature （hyperthermia or hypothermia）,weaker cry or moan,apnea,dystonia, bulging fontanel and an not obvious abnormal WBC counts.72.7% of neonatal purulent meningitis have an elevated CRP.Cerebrospinal fluid WBC and protein counts both increased. Three cases,accounting for 16.79%,had an elevated glucose in gerebrospinal fluid which was more than 2.2 mmol/L,and the main pathogens were staphylococcus and escherichia coli. Conclusion It was not typical at the early stage of neonatal purulent meningitis,and its treatment key to have an examination of cerebrospinal fluid as soon as possible in order to guide reasonable use of antibiotics.