新生儿化脓性脑膜炎早期诊断和治疗(附31例报告)

摘要

目的 探讨新生儿化脓性脑膜炎(以下简称化脑)的早期诊断和治疗方法.方法 回顾性分析2004年5月至2008年6月我们收治的新生儿化脓性脑膜炎31例患儿的临床资料,总结早期诊治的经验.结果 新生儿化脑早期表现不典型,中枢神经系统表现缺乏特异性,惊厥多为微小型,早期诊断困难.本组治愈21例,约占67.7%,3例死亡患儿发病至就诊时间均超过48 h,其中2例出生体重＜2500 g;存活者11例合并神经系统并发症,约占42.3%.结论 新生儿化脑病死率和致残率较高,早发现、早诊断、积极治疗为改善预后之关键,临床应动态观察、及时脑脊液检查并全面分析,重视治疗中的影像学检查,以便早期发现并发症.%Objective To investigate the methods of early diagnosis and treatment in neonatal purulent meningitis.Methods clinical datas of 31 cases with neonatal purulent meningitis were collected and analyzed retrospectively from May 2004 to June 2008.Results Early clinical manifestation was atypical in neonatal purulent meningitis.Manifestation of central nervous system defected specificity.The convulsion was mainly D form.It was difficult to make early diagnosis.Twenty -one cases were cured,accounting for 67.7%.It spent more than 24 hours from onset to visit doctor in 3 death cases.The weight were ＜ 2500 g in 2 of 3 death cases.Complication in nervous system was found in 11 survivals,accounting for 42.3%.Conclusions The mortality and disability rate are very high in neonatal purulent meningitis.Early find, diagnosis and active treatment are key factors to improve the prognosis.