新生儿与小婴儿化脓性脑膜炎53例临床分析

Clinical analysis of 53 cases of neonatal and infantile purulent meningitis

目的探讨新生儿、小婴儿化脓性脑膜炎(简称化脑)的临床表现及转归。方法对53例确诊为化脑的年龄<5个月的患儿进行临床回顾性分析。按发病年龄分为新生儿组、小婴儿组,从临床表现、实验室检查、病原学检测、治疗和颅脑磁共振检查及转归方面对两组进行比较。结果新生儿、小婴儿化脑均以发热、反应差、黄疸、纳差为主要表现,小婴儿组发热较新生儿组显著增多,差异有统计学意义(P<0.05);新生儿组黄疸相比小婴儿组显著增多,差异有统计学意义(P<0.05)。新生儿组中合并败血症者较小婴儿组显著增多,差异有统计学意义(P<0.05)。两组患儿病原菌培养大肠埃希菌占比最高。新生儿、小婴儿化脑易发生硬膜下积液、脑室炎、脑积水。结论新生儿、小婴儿化脑危害较为严重,早期识别依赖于临床观察,还需及时行脑脊液、磁共振等检查,采取多种有效的方法积极治疗。

Objective:To investigate Similarities and differences of the clinical characteristics and prognosis of neonatal and infantile Purulent meningitis.Methods:53 cases of infants<5 months diagnosed as Purulent meningitis were retrospective analysis,those cases were divided into neonatal group and infantile group according to the ages.The two groups were compared from the aspects of clinical characteristics,laboratory examination,Pathogenic detection,treatment,and brain magnetic resonance examination and Prognosis.Results:For both newborns and infants with encephalitis,the main symptoms are fever,poor responsiveness,jaundice,and poor appetite.The infant group had a significantly higher incidence of fever compared to the newborn group,with a statistically significant difference(P<0.05).Jaundice was significantly more common in the newborn group compared to the infant group,and the difference was statistically significant(P<0.05).The incidence of sepsis was significantly higher in the newborn group compared to the infant group(P<0.05).In both groups,Escherichia coli was the most common bacterium found in cultures.Encephalitis in newborns and infants can easily lead to complications such as subdural effusion,ventriculitis,and hydrocephalus.Conclusion:Encephalitis in newborns and infants is quite severe.Early identification relies on clinical observation,and it's essential to promptly carry out cerebrospinal fluid tests,magnetic resonance imaging,and other examinations.Multiple effective treatment methods should be actively pursued.