新生儿不典型化脓性脑膜炎26例临床特点回顾性分析(1)
[摘要] 目的 探究26例新生儿不典型化脓性脑膜炎临床特点。方法 整群选取回顾性分析该院2013年2月—2015年4月收治的26例罕见性新生儿不典型化脓性脑膜炎临床资料，分析患儿发病时临床表现、诊断方法、治疗方法及治疗效果等。结果 新生儿不典型化脓性脑膜炎发病初期临床症状不明显，实验室检查一般难以作出正确的诊断，脑脊液检查结果和典型的化脓性脑膜炎有较大的差异，临床诊断该病难度较大；患儿经抗感染、降颅压、肾上腺素、抗惊厥等对症治疗以后，患儿均治愈出院，无死亡病例，治疗后出现神经系统后遗症3例，其中合并硬膜下积液1例，癫痫1例。 结论 新生儿不典型化脓性脑膜炎临床症状不典型，容易出现误诊、漏诊，研究清楚新生儿不典型化脓性脑膜炎临床特点，可为临床诊断、治疗提供可靠依据，以提升治疗治疗效果，降低死亡率，改善患儿预后。
[关键词] 新生儿不典型化脓性脑膜炎；临床特点；回顾性分析；症状
[中图分类号] R54 [文献标识码] A [文章编号] 1674-0742(2016)01(a)-0118-03
Retrospective Analysis of Clinical Characteristics of 26 Cases with Atypical Purulent Meningitis in Newborns
ZHANG Na-na
Pediatrics， Hechi first people's Hospital， 546300 China
[Abstract] Objective To discuss the clinical characteristics of 26 cases with Atypical purulent meningitis in newborns. Methods The clinical materials of 26 cases with rare atypical purulent meningitis in newborns treated in our hospital from February 2013 to April 2015 were retrospectively analyzed and the clinical performance， diagnostic method， treatment method and treatment effect of the patients were analyzed. Results The clinical symptoms of atypical purulent meningitis in newborns at the initial stage were not obvious， the correct diagnosis was difficult to be made by laboratory examination， the difference in cerebrospinal fluid examination results between atypical purulent meningitis in newborns and typical purulent meningitis， the difficulty in the clinical diagnosis of the disease was big； after the symptomatic treatments of anti-infection， lowering intracranial pressure， adrenaline and anticonvulsants， all patients were cured and discharged without death cases， after treatment， 3 cases were with neurological sequelae， including 1 case with subdural effusion， 1 case with epilepsia. Conclusion The clinical symptoms of atypical purulent meningitis in newborns were not typical and prone to misdiagnosis and missed diagnosis， and the clear research of the clinical characteristics of atypical purulent meningitis in newborns can provide reliable basis for clinical diagnosis and treatment in order to improve the treatment effects， decrease the death rate and improve the prognosis of patients.
[Key words] Atypical purulent meningitis in newborns； Clinical characteristics； Retrospective analysis； Symptom
化脓性脑膜炎主要由于细菌感染导致的患儿急性中枢系统发生感染，脑膜受累，并伴有弥漫性脑水肿及闭塞性小血管炎的炎性病理改变[1]。由于新生儿免疫功能低下，且脑血屏障功能较差，因而发病率较高；该病春季发病相对居多，发病年龄高峰为5～12个月[2]。新生儿发病临床症状不明显，故而容易造成误诊、漏诊，延误最佳治疗时机，最终导致患儿遗留神经系统遗症，给患儿造成终生伤害[3]。因而分析新生儿不典型化脓性脑膜炎临床特点十分重要，可为临床诊断及治疗提供可靠依据，提升患儿治愈率，改善预后，确保患儿安全[4]。整群选取该院2013年2月—2015年4月收治的26例新生儿不典型化脓性脑膜炎进行临床资料回顾性分析，探究其临床特点，取得一定成果，现报道如下。 (张娜娜)
[关键词] 新生儿不典型化脓性脑膜炎；临床特点；回顾性分析；症状
[中图分类号] R54 [文献标识码] A [文章编号] 1674-0742(2016)01(a)-0118-03
Retrospective Analysis of Clinical Characteristics of 26 Cases with Atypical Purulent Meningitis in Newborns
ZHANG Na-na
Pediatrics， Hechi first people's Hospital， 546300 China
[Abstract] Objective To discuss the clinical characteristics of 26 cases with Atypical purulent meningitis in newborns. Methods The clinical materials of 26 cases with rare atypical purulent meningitis in newborns treated in our hospital from February 2013 to April 2015 were retrospectively analyzed and the clinical performance， diagnostic method， treatment method and treatment effect of the patients were analyzed. Results The clinical symptoms of atypical purulent meningitis in newborns at the initial stage were not obvious， the correct diagnosis was difficult to be made by laboratory examination， the difference in cerebrospinal fluid examination results between atypical purulent meningitis in newborns and typical purulent meningitis， the difficulty in the clinical diagnosis of the disease was big； after the symptomatic treatments of anti-infection， lowering intracranial pressure， adrenaline and anticonvulsants， all patients were cured and discharged without death cases， after treatment， 3 cases were with neurological sequelae， including 1 case with subdural effusion， 1 case with epilepsia. Conclusion The clinical symptoms of atypical purulent meningitis in newborns were not typical and prone to misdiagnosis and missed diagnosis， and the clear research of the clinical characteristics of atypical purulent meningitis in newborns can provide reliable basis for clinical diagnosis and treatment in order to improve the treatment effects， decrease the death rate and improve the prognosis of patients.
[Key words] Atypical purulent meningitis in newborns； Clinical characteristics； Retrospective analysis； Symptom
化脓性脑膜炎主要由于细菌感染导致的患儿急性中枢系统发生感染，脑膜受累，并伴有弥漫性脑水肿及闭塞性小血管炎的炎性病理改变[1]。由于新生儿免疫功能低下，且脑血屏障功能较差，因而发病率较高；该病春季发病相对居多，发病年龄高峰为5～12个月[2]。新生儿发病临床症状不明显，故而容易造成误诊、漏诊，延误最佳治疗时机，最终导致患儿遗留神经系统遗症，给患儿造成终生伤害[3]。因而分析新生儿不典型化脓性脑膜炎临床特点十分重要，可为临床诊断及治疗提供可靠依据，提升患儿治愈率，改善预后，确保患儿安全[4]。整群选取该院2013年2月—2015年4月收治的26例新生儿不典型化脓性脑膜炎进行临床资料回顾性分析，探究其临床特点，取得一定成果，现报道如下。 (张娜娜)