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目的探讨新生儿化脓性脑膜炎的后遗症发生情况及严重程度,评估预后。方法 2002年1月至2011年9月在我院新生儿科住院的诊断为新生儿化脓性脑膜炎的398例患儿作为研究对象,采用门诊、电话、信函方式进行随访。随访内容包括生长发育、智能发育情况、运动行为能力等,对门诊随访患者进行格塞尔(Gesell)智能发育筛查。结果 398例患儿中随访147例,随访率为36.9%。其中6例在自动出院后3个月内死亡;余141例中31例(22.0%)出现不同程度的后遗症,惊厥11例(7.8%),智能发育落后10例(7.1%),脑积水6例(4.3%),运动障碍5例(3.5%),视力障碍4例(2.8%),认知障碍2例(1.4%),听力障碍1例(0.7%),脑瘫1例(0.7%),脑性肥胖1例(0.7%)。19例患儿行Gesell智能筛查,评定发育商为84.28±10.76,低于与自身实际年龄相符的发育商(P<0.01);精细运动发育商为74.95±20.71,落后显著(P<0.01);语言发育商为94.68±17.38,与其实际年龄相符的发育商相比无明显差异(P=0.199)。结论新生儿化脓性脑膜炎仍是一种严重的感染性疾病,其后遗症的发生率较高,临床医师需对患儿进行随访追踪,早期实施干预以降低后遗症的发生。
Objective To investigate the occurrence and severity of sequelae of neonatal purulent meningitis and evaluate the prognosis. Methods From January 2002 to September 2011, 398 children diagnosed as Neonatal purulent meningitis in our department of neonatology were enrolled in this study. Patients were followed up by telephone, mail and outpatient service. Follow-up including growth and development, mental development, motor performance, etc., out-patient follow-up of Gesell (Gesell) intelligent development screening. Results A total of 398 children were followed up in 147 cases, the follow-up rate was 36.9%. Among them, 6 cases died within 3 months after they were discharged from hospital. 31 cases (22.0%) of the 141 cases showed various degrees of sequelae, 11 cases (7.8%) of seizures, 10 cases (7.1%) of poor intelligence development, hydrocephalus 6 cases (4.3%), 5 cases of dyskinesia (3.5%), 4 cases of visual impairment (2.8%), 2 cases of cognitive impairment (1.4%), 1 case of hearing impairment (0.7% ), Cerebral obesity in 1 case (0.7%). Nineteen children underwent Gesell intelligent screening, with a rated growth of 84.28 ± 10.76, which was lower than that of their actual age (P <0.01), that of fine motor development was 74.95 ± 20.71 (P <0.01) ; Language development was 94.68 ± 17.38, no significant difference (P = 0.199) compared with the actual age. Conclusion Neonatal purulent meningitis is still a serious infectious disease, the incidence of sequelae is high, clinicians need to follow-up of children, early intervention to reduce the occurrence of sequelae.