小儿化脓性脑膜炎38例临床分析

目的探讨小化脓性脑膜炎的临床表现、诊断、治疗及预后。方法对38例婴幼儿化脓性脑膜炎的临床资料进行回顾性的分析。结果38例患儿临床主要表现为发热（92．1％）、呕吐（47．4％）、惊厥（42．1％）、脑膜刺激征阳性（44．7％）、前囟紧张（34．2％），治愈27例（71．0％），好转8例（21．1％），转外科治疗3例（7．9％）。治疗前脑脊液检查外观混浊、球蛋白阳性检出率分别为73．7％和92．1％，高于治疗后的7．9％和5．3％，差异均有统计学意义（P〈0．05）。且治疗后白细胞数、蛋白定量、葡萄糖定量均降低（P〈0．05）。结论小儿化脓性脑膜炎临床表现不典型，确诊依赖于脑脊液检查，应用敏感有效的抗生素、辅以地塞米松治疗，可提高治愈率，降低病死率，减少并发症及后遗症。

Clinical analysis of 38 cases with infantile purulent meningitis

Objective To investigate the clinical manifestation,diagnosis,treatment and prognosis of patients with purulent meningitis.Methods All of 38 infantile patients with purulent meningitis were analyzed retrospectively.Results In the 38 cases,the main clinical manifestation were fever(92.1%),vomiting(47.4%),seizure(42.1%),meningeal irritation-positive(44.7%),fontanel full(34.2%),27 cases got well(71.0%),8 cases improved(21.1%),3 cases transferred surgical treatment(7.9%).CSF examination before treatment,the appearance of dark cloud,globulin positive rate was 73.7% and 92.1%,higher than 7.9% and 5.3% after treatment,the difference were statistically treatment significant(P < 0.05).White blood cell count,protein and glucose quantitative decreased after treatment(P < 0.05).Conclusion The clinical manifestation of purulent meningitis is not typical,diagnosis depends on the cerebrospinal fluid examination,effective use of antibiotics and complementary with dexamethasone,can increase the cure rate,reduce mortality,complications and sequela.