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目的对比分析早产儿、足月儿化脓性脑膜炎的临床特点。方法总结该院新生儿科2009年7月-2015年7月诊断的66例化脓性脑膜炎患儿的临床特点,依据胎龄分为早产儿组(<37周)和足月儿组(37~42周),对两组临床特点进行对比分析。结果新生儿化脓性脑膜炎主要表现为发热、反应差、食奶差、抽搐、嗜睡、易激惹、颅缝增宽、肌张力低下或增高;足月儿以发热、反应差、抽搐多见;早产儿以肌张力低下多见;早产儿多为院内感染,足月儿多为社区感染;早产儿组脑脊液中葡萄糖水平较足月儿组降低,蛋白水平较足月儿组升高。结论新生儿化脓性脑膜炎缺乏特异性,早产儿表现更为隐匿,临床工作中需密切观察患儿的临床表现,积极完善具有感染高危因素患儿的脑脊液检查,争取早期诊断,合理治疗。
Objective To compare and analyze the clinical features of purulent meningitis in term infants. Methods The clinical features of 66 cases of purulent meningitis diagnosed from July 2009 to July 2015 in our hospital were summarized. According to the gestational age, they were divided into preterm group (<37 weeks) and term group (37 ~ 42 weeks), the clinical features of two groups were analyzed. Results neonatal purulent meningitis mainly manifested as fever, poor response, poor milk, convulsions, drowsiness, irritability, widening cranial suture, low or elevated muscle tone; full-term children with fever, poor response, convulsions more common Premature infants with low muscle tension more common; premature infants mostly hospital infection, term infants and young children more for community infection; premature children cerebrospinal fluid glucose levels were lower than those in full-term children, protein levels than full-term children increased. Conclusions Neonatal purulent meningitis lacks specificity and the performance of premature children is more obscure. Clinical work should be closely observed the clinical manifestations of children, and actively improve the cerebrospinal fluid examination in children with high risk factors for early diagnosis and reasonable treatment.