颅内感染患儿的超声诊断与感染相关因素分析

Related factors for intracranial infections in children and diagnostic value of transcranial Doppler ultrasound

目的探讨患儿颅内感染的相关因素和经颅多普勒超声的诊断价值,以降低感染发生率。方法选取2009年12月-2012年12月在神经外科治疗的31例颅内感染患儿临床资料进行回顾性分析,另外随机选取50例同期未发生颅内感染的患儿作为对照,分别比较两组的危险因素和经颅多普勒超声的差异。结果患儿年龄小、病程长、住院时间长、昏迷、抗菌药物使用时间长、贫血、多种并发症、使用大量丙种球蛋白均是颅内感染的危险因素,其中年龄、意识状态、抗菌药物使用和住院时间均是颅内感染的高危险因素(P=0.012、0.033、0、009、0.016)。结论经颅多普勒超声则可反映出患儿脑炎的脑血管痉挛、狭窄和颅内压情况,该检查是判断病情、评价疗效和预后不可或缺的辅助检查。

OBJECTIVE To explore the related factors for intracranial infections in children and assess the value of transcranial Doppler ultrasound in diagnosis so as to reduce the infection rate. METHODS The clinical data of 31 patients with intracranial infections who were treated in the neurosurgery department from Dec2009 to Dec 2012 were retrospectively analyzed, meanwhile another 50 children without intracranial infections were set as the controls, then the risk factors for the intracranial infections and the difference in the transcranial Doppler ultrasound were compared between the two groups. RESULTS The young age, long illness course, long length of hospitalization, coma, long-term use of antibiotics, anemia, multiple complications, and use of a large number of gamma globulin were all the risk factors for the lntracranial infections, among which the age, consciousness state, use of antibiotics, and length of hospitalization were the independent risk factors for the intracranial infections （P = 0.012,0.033,0.009, and 0.016）. CONCLUSION The transcranial doppler ultrasound may reflect the status of cerebral vasospasm, stenosis, or intracranial pressure of the children and can serve as an auxiliary examination for prognosis, condition determination as well as the evaluation of therapeutic effect.