小儿化脓性脑膜炎的临床及病原学分析

Etiological Analysis on Clinical Features and Etiology of Childhood Purulent Meningitis

目的探讨本地区小儿化脓性脑膜炎的临床及病原学分析,为临床诊治提供依据。方法回顾分析我院2011年3月—2013年8月诊断的88例儿童化脓性脑膜炎的临床资料。结果 88例化脓性脑膜炎患儿中,婴儿57例(64.8%),幼儿23例(26.1%),学龄前期及学龄期儿童8例(9.1%);88例患儿中出现发热85例(96.6%),惊厥66例(75.0%),昏迷25例(28.4%),呕吐28例(31.8%),头痛10例(11.4%),脑膜刺激征11例(12.5%);脑脊液和血培养阳性率均为12.5%;革兰氏阳性球菌有肺炎链球菌和李斯特菌,革兰氏阴性菌有大肠杆菌、洛菲不动杆菌、流感嗜血杆菌和肺炎克雷伯菌。结论本病以发热、惊厥和昏迷为主要临床表现,3岁以下婴幼儿感染菌主要为革兰氏阴性菌,3岁以上感染菌主要为革兰氏阳性菌,条件致病菌增多。

OBJECTIVE To explore the etiology of purulent meningitis in children in local district to provide scientific basis for diagno-sis and treatment.METHODS Clinical data of children with bacterial meningitis admitted in the Second Hospital of Lanzhou Univer-sity from March 2011 to August 2013 were analyzed.RESULTS 88 cases of purulent meningitis,including 57 infants（64.8%）,23toddlers（26.1%）,8 preschool and school-age children（9.1%）.The clinical manifestations of patients mainly were fever（96.6%）,sei-zures 75.0%,coma 28.4%,vomiting 31.8%,headache 11.4%,and meningeal irritation sign were 12.5%. The positive rate of cere-brospinal fluid and blood were 12.5%. Gram positive coccus have streptococcus pneumonias and Listeria monocytogenes,gram nega-tive bacteria have Escherichia coli, Acinetobacter lwoffii, Haemophilus influenzae,Klebsiella pneumoniae. CONCLUSIONS Majorclinical manifestations are fever,seizures,coma and vomiting in most patients,gram-negative bacteria were mainly pathogens in in-fants and toddlers purulent meningitis. Gram positive bacteria were mainly pathogens in Children over the age of 3. Conditioned patho-gen increased.