儿童难治性化脓性脑膜炎的影响因素研究

Study on the influencing factors of refractory suppurative meningitis in children

目的探讨儿童难治性化脓性脑膜炎的影响因素.方法选取2014年10月至2018年10月本院收治的化脓性脑膜炎患儿96例进行回顾性分析,根据其疾病类型将其分为难治性化脓性脑膜炎研究组和普通性化脓性脑膜炎对照组.结果研究组在发病季节、早期症状、体温反复、体温恢复时间以及颅脑影像学改变方面与对照组比较差异有统计学意义(P<0.05),研究组在年龄、性别、体质量、前驱感染以及确诊时间方面与对照组比较差异无统计学意义;研究组CRP、脑脊液常规(蛋白定性)、细胞总数、ADA、GLU、LDH、CL、蛋白定量以及脑脊液培养与对照组比较差异有统计学意义(P<0.05),研究组血培养、N、L、单核细胞比例与对照组比较差异无统计学意义;经多因素分析,前囟门隆起、体温恢复时间长、CRP明显升高以及ADA明显降低是难治性化脓性脑膜炎的独立危险因素(P<0.05).结论难治性化脓性脑膜炎的独立危险因素包含前囟门隆起、体温恢复时间长、CRP明显升高以及ADA明显降低,在疾病治疗时可根据患儿表现情况进行针对性治疗.

Objective To investigate the influencing factors of refractory suppurative meningitis in children. Methods A retrospective analysis was performed on 96 children with suppurative meningitis admitted to our hospital from October 2014 to October 2018. According to their disease types, they were divided into refractory suppurative meningitis research group and common suppurative meninges. Inflammation control group. Results The study group had statistically significant differences in the onset season, early symptoms, temperature recurrence, temperature recovery time and brain imaging changes (P<0.05). The study group was age, gender, body weight, and pre-infection. There was no significant difference in the time of diagnosis and the control group. The CRP, cerebrospinal fluid routine (protein characterization), total cell count, ADA, GLU, LDH, CL, protein quantification and cerebrospinal fluid culture were significantly different from the control group (P<0.05), the blood culture, N, L, and monocyte ratios of the study group were not significantly different from those of the control group. After multivariate analysis, the anterior cardia bulge, body temperature recovery time, CRP increased significantly, and ADA was obvious. Reduction was an independent risk factor for refractory purulent meningitis (P<0.05). Conclusion Independent risk factors for refractory purulent meningitis include anterior cardia bulge, long recovery time, elevated CRP, and significant reduction in ADA. Targeted treatment can be performed according to the performance of the disease during treatment.