100例新生儿不同病原菌化脓性脑膜炎的临床分析及预后因素

目的:分析新生儿不同病原菌化脓性脑膜炎的临床特点及预后因素.方法:回顾性分析本院2013年1月~2017年1月收治的100例新生儿化脓性脑膜炎患儿的相关资料,比较不同病原菌化脓性脑膜炎脑脊液检查结果、白细胞计数、发热持续时间等指标及预后情况,并通过多元线性逐步回归分析影响患儿预后的相关因素.结果:大肠埃希菌组脑脊液浑浊及脓性率均显著高于其他细菌组、病原菌不明组(66.67%vs.20.83%、16.39%,26.67%vs.4.17%、4.92%;大肠埃希菌组白细胞计数、发热持续时间、脑脊液恢复时间、住院时间均显著大于,脑脊液糖水平显著低于及预后不良率显著高于其他细菌组、病原菌不明组;多元线性逐步回归分析显示影响新生儿化脓性脑膜炎预后不良的独立危险因素为白细胞计数>500×106/L.结论:大肠埃希菌感染患儿脑脊液以浑浊、脓性为主,白细胞计数水平显著高,预后差;脑脊液糖浓度低、白细胞计数高是新生儿化脓性脑膜炎预后不良独立危险因子.

Clinical characteristics and prognosis associated factors of neonatal purulent meningitis caused by different pathogens in 100 cases

Objective To analyze the clinical characteristics and prognosis associated factors of neonatal purulent menin-gitis caused by different pathogens. Methods The related data of 100 neonates with purulent meningitis treated in our hospital from January 2013 to January 2017 were retrospectively analyzed. The detection results of cerebrospinal fluid, white blood cell count, duration of fever and prognosis associated factors were compared among neonates with purulent meningitis caused by dif-ferent pathogens. The related factors influencing the prognosis of neonates were analyzed by multiple linear stepwise regression analysis. Results The rate of cerebrospinal fluid turbidity and purulence was significantly higher in Escherichia coli group than other bacteria group and unknown pathogen group (66.67% vs. 20.83%, 16.39%, 26.67% vs. 4.17%, 4.92%). The white blood cell count, duration of fever, cerebrospinal fluid recovery time and length of hospital stay of Escherichia coli group were sig-nificantly higher and longer, glucose level in cerebrospinal fluid was significantly lower, rate of poor prognosis was significantly higher than those in other bacteria group and unknown pathogen group. Multiple linear stepwise regression analysis showed that the independent risk factor influencing the prognosis of neonatal purulent meningitis was white blood cell count >500×106/L. Conclusion The cerebrospinal fluid of neonates infected by Escherichia coli isturbid and purulent, white blood cell count is significantly higher, and the prognosis is worse. Low glucose level in cerebrospinal fluid and high white blood cell count are in-dependent risk factors of poor prognosis of neonatal purulent meningitis.