婴儿晚发型B族链球菌化脓性脑膜炎24例分析

发布时间：2018-04-16 01:06

本文选题：B族链球菌 + 化脓性脑膜炎　；参考：《山东医药》2017年15期

【摘要】：目的分析婴儿晚发型B族链球菌(GBS)化脓性脑膜炎的特点、治疗效果及转归情况,并与非GBS化脓性脑膜炎进行比较。方法 GBS化脓性脑膜炎患儿24例纳入GBS组,以同期收治的21例非GBS化脓性脑膜炎患儿作为对照组,收集两组患儿的的临床表现、实验室检查结果、影像学检查结果、治疗转归及预后资料并比较。结果两组常见表现为发热、喂养困难、反应差、气促呻吟等。GBS组患儿外周血CRP高于对照组(P0.01),脑脊液葡萄糖水平低于对照组(P0.05),GBS组合并轻中度贫血比例高于对照组(P0.05)。GBS组头颅MRI检查发现并发症发生率高于对照组(P0.05)。GBS组采用青霉素类联合头孢曲松治疗4例,余均予万古霉素联合三代头孢或美罗培南治疗;对照组选择三代头孢、美罗培南或万古霉素治疗。GBS组患儿住院时间、脑脊液葡萄糖水平恢复正常所需时间较对照组延长(P均0.05)。随访2个月~3.5年,GBS组生长发育基本正常7例、运动发育落后8例、癫痫发作1例、放弃治疗后死亡3例、失访5例。对照组生长发育基本正常8例、运动发育落后4例、癫痫发作2例、放弃治疗后死亡4例、失访3例。两组预后情况差异无统计学意义。结论晚发型GBS化脓性脑膜炎临床表现无特异性,与非GBS化脓性脑膜炎相比更易合并贫血、治疗周期长、并发症发生率较高。
[Abstract]:Objective to analyze the characteristics, therapeutic effect and outcome of late onset group B streptococcus B purulent meningitis in infants, and to compare it with non GBS suppurative meningitis.Methods 24 cases of GBS suppurative meningitis were included in GBS group. 21 cases of non- suppurative meningitis treated in the same period were used as control group. The clinical manifestations, laboratory results and imaging findings of the two groups were collected.The outcome and prognosis of treatment were compared.Results the common symptoms of the two groups were fever, difficult feeding and poor response.The peripheral blood CRP and CSF glucose level in the GBS group were higher than those in the control group (P 0.05) and the proportion of mild to moderate anemia was higher than that in the control group (P 0.05). The incidence of complications in the GBS group was higher than that in the control group (P 0.05). The incidence of complications was higher in the GBS group than that in the control group (P 0.05). The incidence of complications in the GBS group was higher than that in the control group (P 0.05).Four cases were treated with penicillin combined with ceftriaxone.The rest were treated with vancomycin combined with third generation cephalosporin or meropenem, and those in the control group were treated with the third generation cefosporin, meropenem or vancomycin, and the time required for cerebrospinal fluid glucose level to return to normal was longer than that in control group (P < 0.05).The patients in GBS group were followed up for 2 months to 3.5 years. In GBS group, 7 cases were normal, 8 cases were dyskinesia, 1 case was epileptic attack, 3 cases died after giving up treatment, 5 cases lost visit.In the control group, there were 8 cases of normal growth and development, 4 cases of motor retardation, 2 cases of epileptic seizures, 4 cases of death after giving up treatment, and 3 cases of missing visits.There was no significant difference in prognosis between the two groups.Conclusion late onset GBS suppurative meningitis has no specific clinical manifestations. Compared with non- suppurative meningitis, it is more likely to be associated with anemia, with a longer treatment cycle and a higher incidence of complications.
【作者单位】：青岛大学附属青岛妇女儿童医院;
【基金】：山东省医药卫生科技发展计划项目(2015WS0356)
【分类号】：R742.9

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