新生儿化脓性脑膜炎15例临床分析

目的探讨新生儿化脓性脑膜炎的临床特点和治疗效果。方法回顾性分析安徽芜湖市第一人民医院新生儿科2012年6月—2013年6月收治的15例新生儿化脓性脑膜炎的临床资料。结果发热11例（73.3%）;嗜睡、反应低下7例（46.7%）;少吃、少哭或拒奶5例（33.3%）,黄疸5例（33.3%）,前囟紧张、饱满8例（53.3%）;肌张力增高4例（26.7%）;眼神呆滞、凝视3例（20%）;惊厥3例（20%）;腹胀6例（40%）,呼吸暂停伴皮肤青紫1例（6.67%）。肺出血1例（6.67%）。治愈9例,好转4例,转上级医院1例,自动出院1例,无死亡病例。结论新生儿化脓性脑膜炎无典型的临床表现,可在败血症的基础上,细菌侵入脑膜而患病。临床症状和体征无特异性,诊断识别有赖于细致的临床观察、血培养及脑脊液检查,合理应用有效抗生素、有力的支持疗法和积极周密的护理是提高治愈率的关键。

Analysis of 15 cases of newborns with purulent meningitis

Objective To investigate the clinical characteristic and treatment effect of neonatal purulent meningitis.Methods A retrospective analysis of clinical data of 15 cases of neonatal purulent meningitis from June 2012 to June2013 was conducted. Results Fever occurred in 11 cases（73. 3%）,drowsiness and low reaction in 7 cases（46. 7%）,eat less,less crying or refusing milk in 5 cases（33. 3%）,jaundice in 5 cases（33. 3%）,bregmatic tonus,full in 8 cases（53.3%）,hypermyotonia in4 cases（26.7%）,dull eyes,staring in3 cases（20%）,eclampsia in3 cases（20%）,abdominal distension in 6 cases（40%）,apnea with cyanotic skin in 1 case（6. 67%）,pneumorrhagia in 1 case（6. 67%）. 9 cases were cured,4 cases were improved,1 case was turned to higher hospital,and 1 case automatically discharged,no death occurred in 15 cases. Conclusion Purulent meningitis in newborns had no typical clinical manifestations,sepsis can be based on the prevalence of bacteria invade the meninges. Diagnosis of it wad depended on careful clinical observation,blood culture and cerebrospinal fluid examination,rational application of effective antibiotics,a strong supportive therapy and positive thorough care was the key to improve the cure rate.