新生儿化脓性脑膜炎的早期诊断与治疗效果分析

Analysis on Early Diagnosis and Treatment Effect of Neonatal Purulent Meningitis

目的探讨新生儿化脓性脑膜炎的早期诊断与治疗效果。方法对36例化脓性脑膜炎患儿分别予以头孢曲松钠和美罗培南治疗,分析患儿的临床特征、实验室检查及治疗效果。结果 36例确诊化脓性脑膜炎新生儿临床主要症状为高热、惊厥、前囟饱满、喷射状呕吐、呼吸暂停等。CSF常规检查中白细胞计数为（22.5-602.50）×10^6/L,糖定量为0.34-4.11μmol/L,蛋白定量为0.2-12 g/L,外周血白细胞计数为（4.7-39.15）×10^9/L。治疗1个月后,美罗培南组治愈好转率明显高于头孢曲松组（P〈0.05）,但两组并发症发生率比较差异无统计学意义（P〉0.05）。结论新生儿化脓性脑膜炎可结合临床表现、CSF培养及PCR检测进行诊断;美罗培南有利于提高治疗效果。

Objective To study the early diagnosis and treatment effect of neonatal purulent meningitis. Methods 36 newborns with purulent meningitis were treated with ceftriaxone and meropenem respectively. The clinical features, results of laboratory examination and therapeutic effect of newborns were analyzed. Results The main clinical symptoms of 36 newborns with purulent meningitis were high fever, convulsions, full bregma, spurting vomiting, apnea, etc. In CSF routine examination, the WBC count was（22.5 - 602.50） × 10^6/L, the sugar quantification was 0.34 - 4.11 μmol/L, the protein quantification was 0.2 - 12 g/L, the WBC count in peripheral blood was（4.7 -39.15） × 10^9/L. 1 month after the treatment, the cure rate of meropenem group was higher than that of ceftriaxone group（P〈0.05）, but the incidence of complications of two groups had no statistical difference（P〉0.05）. Conclusions Neonatal purulent meningitis can be diagnosed by clinical manifestations, CSF culture and PCR detection. Meropenem is beneficial to improve the treatment effect.