颅脑超声在诊断新生儿中枢神经系统感染中的应用

The application of craniocerebral ultrasound in the diagnosis of neonatal central nervous system infection

目的探讨颅脑超声对不同类型新生儿中枢神经系统感染的诊断价值。方法选取我院2017年1月~2019年1月收治的75例新生儿中枢神经系统感染(化脓性脑膜炎43例,病毒性脑膜炎22例,结核性脑膜炎10例)患儿为观察对象,均行颅脑超声检查,统计不同感染类型患儿颅脑超声阳性率、脑室扩张检出率、脑积水检出率、硬膜下积液检出率、脑水肿检出率、脑实质改变检出率。结果化脓性脑膜炎、病毒性脑膜炎、结核性脑膜炎患儿性别、胎龄、体质量、日龄差异均不明显(P>0.05);化脓性脑膜炎、病毒性脑膜炎、结核性脑膜炎颅脑超声回声异常检出率93.02%、13.64%、100.00%,脑室扩张检出率100.00%、54.55%、100.00%,脑积水检出率53.49%、18.18%、50.00%,硬膜下积液检出率62.79%、4.55%、70.00%,脑水肿检出率34.88%、13.64%、10.00%,脑实质改变检出率30.23%、90.91%、10.00%,差异均有统计学意义(P<0.05)。结论新生儿中枢神经系统感染的颅脑超声表现具有特异性,为临床鉴别化脓性脑膜炎、病毒性脑膜炎和结核性脑膜炎提供重要依据。

Objective To investigate the value of craniocerebral ultrasound in the diagnosis of neonatal central nervous system infection in different types.Methods 75 neonatal central nervous system infections (43 cases of purulent meningitis,22 cases of viral meningitis,10 cases of tuberculous meningitis)in our hospital from January 2017 to January 2019 were enrolled as subjects.All underwent brain ultrasound examination.Statistics of craniocerebral ultrasound positive rate,ventricular dilatation detection rate,hydrocephalus detection rate,subdural effusion detection rate,brain edema detection rate,substantial brain change detection rate were performed.Results There were no significant differences in gender,gestational age,body weight and age between children with purulent meningitis,viral meningitis and tuberculous meningitis(P>0.05).The abnormal detection rate of purulent meningitis,viral meningitis and tuberculosis by craniocerebral ultrasound was 93.02%,13.64% and 100.00%.The detection rate of ventricular dilatation was 100.00%,54.55% and 100.00%,and the detection rate of hydrocephalus was 53.49%,18.18% and 50.00%.The detection rate of subdural effusion was 62.79%,4.55% and 70.00%.The detection rate of cerebral edema was 34.88%,13.64% and 10.00%.And the detection rate of substantial brain change was 30.23%,90.91% and 10.00%,all with significant difference(P<0.05).Conclusion The craniocerebral ultrasound findings of neonatal central nervous system infection are specific and provide an important basis for the clinical identification of purulent meningitis,viral meningitis and tuberculous meningitis.