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目的:探讨新生儿化脓性脑膜炎的早期临床特点。方法:选择2008～2010年吉林市儿童医院NICU收治的化脓性脑膜炎患儿,回顾性分析其围生因素、发病时间、临床表现、实验室检查、治疗和预后。结果:新生儿化脓性脑膜炎9例,检出率占同期临床诊断败血症患儿的17.31%,1例早产儿生后6 h发病,表现有反应差、发热、抽搐、硬肿症,1例以屏气发作起病,2例抽搐时出现呼吸停止和频繁呼吸暂停需常频通气治疗,脑脊液常规WBC 42×106/L～脓细胞满视野。2例脑脊液培养阳性,9例血培养均阴性,5例患儿治疗有效,放弃治疗2例,死亡2例。结论:新生儿化脓性脑膜炎起病隐匿,病情重,病死率高,应重视早期临床表现,尽早行病原学检测,选择敏感抗生素治疗,以降低病死率。
Objective: To investigate the early clinical features of neonatal purulent meningitis. Methods: Children with purulent meningitis admitted to NICU of Jilin Children’s Hospital from 2008 to 2010 were retrospectively analyzed for their perinatal factors, onset time, clinical manifestations, laboratory tests, treatment and prognosis. Results: Neonatal purulent meningitis in 9 cases, the detection rate of the same period accounted for 17.31% of children diagnosed with sepsis in the same period, 1 case of premature infants after 6 h onset, the performance of poor response, fever, convulsions, scleredema in 1 case With breath-hold onset, two cases of convulsions appear to stop breathing and frequent apnea required frequent ventilation, cerebrospinal fluid routine WBC 42 × 106 / L ~ pus full field. 2 cases of cerebrospinal fluid culture positive, 9 cases of blood culture were negative, 5 cases of children effective treatment, giving up treatment in 2 cases, 2 patients died. Conclusion: Neonatal purulent meningitis occult onset, severe illness and high mortality, early clinical manifestations should be emphasized, as early as possible pathogenic detection, the choice of sensitive antibiotics to reduce mortality.