美罗培南治疗新生儿化脓性脑膜炎临床效果观察

The clinical efffect of meropenem in the treatment of neonatal purulent meningitis

目的研究美罗培南治疗新生儿化脓性脑膜炎的临床效果。方法选取2012年8月至2015年7月本院新生儿科收治的66例化脓性脑膜炎患儿为研究对象,采用随机数表法将其分为观察组与对照组,每组各33例。两组患儿均行常规治疗,对照组患儿加用头孢曲松钠治疗,观察组患儿在对照组治疗基础上加用美罗培南治疗。比较两组患儿临床疗效、细菌学疗效、治疗前后脑脊液与血清中一氧化氮(NO)和硫化氢(H_2S)水平变化情况及及治疗期间不良反应发生率。结果观察组患儿临床疗效、细菌学疗效均显著优于对照组(P<0.05)。两组患儿治疗后脑脊液与血清中H_2S和NO水平均较治疗前降低(P<0.05),观察组患儿脑脊液与血清中H_2S和NO水平均显著低于对照组(P<0.05)。两组患儿治疗期间不良反应发生率比较差异无显著性(P>0.05)。结论美罗培南治疗新生儿化脓性脑膜炎可获得满意的临床疗效及病原菌清除效果,抗炎作用较单一头孢曲松钠更显著,联合用药多为一过性不良反应,且患儿可耐受,不良反应无明显增加。

Objective To study the clinical efficacy of meropenem in the treatment of neonatal purulent meningitis. Method 66 cases of neonatal purulent meningitis in our hospital from August 2012 to July 2015 were involved and randomly divided into observation group and control group, 33 cases in each group. All cases underwent routine intervention, at this basis, control group children were treated with ceftriaxone sodium therapy, observation group children were treated with meropenem on the basis of control group. Compared the clinical efficacy, bacteriological efficacy, the levels of nitric oxide（NO） and hydrogen sulfide（H_2S） in cerebrospinal fluid and serum before and after treatment and the incidence of adverse reaction during treatment between the two groups. Result The clinical efficacy and bacteriological efficacy of observation group were better than control group（P〈0.05）. After treatment, NO and H2S in serum and cerebrospinal fluid of the two groups declined（P〈0.05）, the above indexes in observation group were significantly lower than control group（P〈0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）. Conclusion Meropenem in the treatment of neonatal purulent meningitis can obtain satisfactory clinical efficacy and pathogen removal effect. It has more significant anti-inflammatory effects than the ceftriaxone sodium. The adverse reactions of combination are most transient, children can tolerance. Adverse reactions do not increase.