儿童化脓性脑膜炎近期不良预后危险因素分析

发布时间：2019-06-06 15:16

【摘要】：目的探讨儿童化脓性脑膜炎近期不良预后的危险因素。方法收集化脓性脑膜炎患儿209例,分为预后良好组33例和预后不良组176例。筛选出可能影响近期预后的因素,单因素分析两组在这些因素方面的差异。结果结果显示,预后不良组年龄小于预后良好组,意识障碍/昏迷、前囟隆起、瞳孔异常、肌张力异常及并发症发生率;脑脊液蛋白含量、糖浓度、乳酸浓度,血白细胞4×109/L或血白细胞12×109/L、血钙3.5 mmol/L、血钠135mmol/L、颅脑CT或MRI检查异常及使用丙种球蛋白患儿比例高于预后良好组,差异有统计学意义(P0.05)。Logistic多因素分析结果显示,低龄、意识障碍或昏迷、瞳孔不等大、脑脊液乳酸升高、血白细胞4×109/L或血白细胞20×109/L与化脓性脑膜炎患儿预后不良独立相关。结论低龄、意识障碍或昏迷、瞳孔不等大、脑脊液乳酸升高、血白细胞4×109/L或血白细胞20×109/L是化脓性脑膜炎近期不良预后的危险因素。临床上应及早识别,早期积极防治。
[Abstract]:Objective to investigate the risk factors of short-term poor prognosis of suppurative meningitis in children. Methods 209 children with suppurative meningitis were divided into good prognosis group (n = 33) and poor prognosis group (n = 176). The factors that may affect the short-term prognosis were screened out, and the differences in these factors between the two groups were analyzed by univariate analysis. The results showed that the age of poor prognosis group was lower than that of good prognosis group, disturbance of consciousness / coma, anterior fontanelle eminence, abnormal pupil, abnormal muscle tension and the incidence of complications. The protein content, glucose concentration, lactic acid concentration, white blood cell 4 脳 109 脳 L or white blood cell 12 脳 109 脳 L, serum calcium 3.5 mmol/L, blood sodium 135 mmol / L, abnormal brain CT or MRI examination and the proportion of children with good prognosis were higher than those in the group with good prognosis. The difference was statistically significant (P 0.05). Logistic multivariate analysis showed that low age, disturbance of consciousness or coma, pupils were not equal, cerebrospinal fluid lactic acid increased. The prognosis of children with suppurative meningitis was independent of 4 脳 109 脳 L or 20 脳 109 / L of blood leukocytes. Conclusion the risk factors of short-term poor prognosis of suppurative meningitis are low age, disturbance of consciousness or coma, unequal pupil size, elevated lactic acid in cerebrospinal fluid and 4 脳 10 ~ 9 脳 10 ~ 9 / L white blood cell or 20 脳 10 ~ 9 脳 10 ~ 9 leukocyte in suppurative meningitis. Clinical should be identified as early as possible, early active prevention and treatment.
【作者单位】：榆林市吴堡县医院儿科;西安交通大学第一附属医院儿科;
【分类号】：R742.9

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