摘要
目的 探讨新生儿化脓性脑膜炎(新生儿化脑)及脑室炎的诊断及治疗。方法 回顾性分析1992年1月至2002年12月我科收治的新生儿化脑59例。结果 新生儿化脑缺乏特异性的症状和体征,临床表现复杂、多样化,一半以上表现为发热或体温不升,拒奶或吐奶,神萎及反应差,黄疸,前囟紧张和末梢白细胞增高等。血培养及脑脊液培养细菌阳性,大部份病人以青霉素/氨苄青霉素加头孢噻肟/头孢三嗪治疗有效,治愈率83.1％。脑室炎患儿还表现为:病程≥1周,发热>3天,频繁抽搐,前囟紧张及脑室扩大等。侧脑室穿刺注药治疗有效,治愈率66.6％。结论 新生儿化脑及脑室炎临床表现复杂、多样化,缺乏特异性,对出现上述临床表现的患儿要及时行腰穿及脑室穿刺,及时诊断治疗,大部分患儿以青霉素/氨苄青霉素加头孢噻肟/头孢三嗪治疗有效,合并脑室炎应侧脑室穿刺注药治疗。
Objective To evaluate the characteristics, diagnosis as and treatment of patients with meningitis and venticulitis in our neonatal unit. Methods Retrospective study of 59 newborn infants diagnosed as bacterial meningitis since January 1992 to December 2002. Results The absence of specific clinical findings made diagnosis of meningitis more difficult in neonates. Presentation of infection was character-ized by symptoms more typically associated with meningitis. These included fever or thermal instability, feeding difficulty, lethargy and poor response, jaundice, bulging fontanel, irritability, respiratory distress and an elevated WBC counts and ratio. CSF or blood culture was poistive It was effective to use Penicillin G/Ampicillin in combination with Cefotaxime/Ceftriaxone in most patients. The rate of effective was 83. l % . The main signs with ventriculitis at the hospital included more than one week' s personai histo ry, fever≥3 days convulsion bulging fontanel poor response to the usual therapy and ventricular dilation. The effective rate of intraventricular chemotherapy in neonatal ventriculitis was 66.6%. Conclution During the neonatal period, a high degree of clinical suspicion and techniques for an early diagnosis and treatment are needed for the neonatal meningitis and ventriculitis. It is effective to use Penicillin G/Ampi cillin in combination with Cefotaxime/Ceftriaxone in most patients. In our experience intraventricular che motherapy as an adjunct to systemic administration of antibiotics has greatly reduced the mortality rate in neonatal bacterial ventriculitis.
出处
《新生儿科杂志》
2004年第5期193-196,共4页
The Journal of Neonatology
关键词
新生儿
化脓性脑膜炎
脑室炎
治疗
Jnfant,newborn
Meningitis
Ventriculitis
Treatment
