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(P<0.05)。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。
Objective To explore the risk factors for a short-term adverse outcome of purulent meningitis in children. Methods 209 cases of purulent meningitis were analyzed and divided into good prognosis group （33 cases） and poor prognosis group 176 cases） .The factors affected short-term prognoses of the two groups were compared. Results The results showed：the patients of lower age tending to poor prognosis group. The disturbance of consciousness or coma, bregmatic eminence, pupil anomalous, dystonia, incidence of complications, cerebrospinal fluid protein content, sugar concentration,lactate levels,leukocytes〈4×10^9 or 〉 12×10^9/L, blood calcium〈3.5 mmol/L, serum sodium〈 135mmol/L, and abnormality of brain CT or MRI in poor prognosis group was higher than good prognosis group. Difference was statistically significant （ P〈0.05 ）. Logistic muhivariable analysis showed that low age, disturbance of consciousness or coma, anisocoria, lactate levels, leukocytes〈 4×10^9 or 〉 12 ×10^9/L were independently associated with a short-term adverse outcome of purulent meningitis. Conclusion The risk factors for a short-term adverse outcome of purulent meningitis in children were low age, disturbance of consciousness or coma, anisocoria,lactate levels and leukocytes〈4×10^9 or 〉 12×10^9/L. Preventive measures must be adopted at an earlier stage.
出处
《中南医学科学杂志》
CAS
2016年第6期657-660,共4页
Medical Science Journal of Central South China
关键词
儿童化脓性脑膜炎
近期不良预后
危险因素
children purulent meningitis
short-term adverse outcome
risk factors
