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目的分析新生儿化脓性脑膜炎的早期临床表现及实验室检查特点。方法回顾性分析25例新生儿化脓性脑膜炎的早期临床表现及血常规、C反应蛋白、脑脊液检查、血培养情况。结果新生儿肺炎是最常见的原发疾病(12例,48%)。临床表现以发热最常见(20例,80%)。外周血最常见的改变为贫血(21例,84%)。脑脊液检查白细胞计数>20×10~6/L者23例(92%)。血培养阳性者10例(40%),以表皮葡萄球菌、金黄色葡萄球菌和大肠埃希菌最常见。脑脊液培养阳性者仅1例(4%),为大肠埃希菌。结论新生儿化脓性脑膜炎最常见的原发疾病是新生儿肺炎,最常见的外周血改变是贫血。脑脊液检查阴性或不典型结果,并不能排除新生儿化脓性脑膜炎的诊断。
Objective To analyze the early clinical manifestations and laboratory features of neonatal purulent meningitis. Methods A retrospective analysis of 25 cases of neonatal purulent meningitis early clinical manifestations and blood, C-reactive protein, cerebrospinal fluid examination, blood culture. Results Neonatal pneumonia was the most common primary disease (12 patients, 48%). The most common clinical manifestations of fever (20 cases, 80%). The most common change in peripheral blood was anemia (21 patients, 84%). Cerebrospinal fluid examination of white blood cell count> 20 × 10 ~ 6 / L in 23 cases (92%). Blood culture positive in 10 cases (40%), Staphylococcus epidermidis, Staphylococcus aureus and Escherichia coli most common. Cerebrospinal fluid culture positive in only 1 case (4%), Escherichia coli. Conclusions The most common primary disease of neonatal purulent meningitis is neonatal pneumonia. The most common change in peripheral blood is anemia. Negative cerebrospinal fluid tests or atypical results, and can not rule out the diagnosis of neonatal purulent meningitis.