儿童化脓性脑膜炎237例随访研究

Follow-up study of 237 children with purulent meningitis

目的探讨未达到停药标准的化脓性脑膜炎患儿的随访情况。方法将郑州大学第一附属医院2014年3月至2017年3月101例出院时脑脊液细胞数异常的化脓性脑膜炎患儿与136例达到出院标准的化脓性脑膜炎患儿分成A、B组进行随访研究,统计分析两组患儿的并发症及远期后遗症。结果两组患儿的院外复发率、后遗症种类及发生率比较,差异未见统计学意义(P>0.05)。结论化脓性脑膜炎患儿,临床症状完全缓解1周以上,抗生素疗程足,连续≥3次腰椎穿刺术复查脑脊液细胞数仍高,分类主要为单核细胞,葡萄糖正常或轻度降低,蛋白<1.0g/L,虽然未达到国内公认的停药出院标准,也可考虑停药观察。

Objective To investigate the follow-up of children with purulent meningitis who failed to meet the withdrawal criteria.Methods One hundred and one children with purulent meningitis with abnormal cerebrospinal fluid cells at discharge and 136 children with purulent meningitis who met discharge criteria in the First Afflilated Hospital of Zhengzhou University from March 2014 to March 2017 were divided into two groups for follow-up study.The complications and long-term sequelae in the two groups were statistically analyzed.Results There was no significant difference in the rate of recurrence and sequelae between the two groups(P>0.05).Conclusions For children with purulent meningitis,of which the clinical symptoms is completely relieved for more than 1 week,and the course of antibiotic treatment is enough,and the number of CSF cells is still high after three times of lumbar puncture,the main categories were monocytes,normal or slightly reduced of glucose,protein<1.0 g/L,although it doesn’t meet the domestic drug withdrawal standard,doctors should also consider stopping medicine.