引用本文:蓝明平,蒋莉.婴儿化脓性脑膜炎并发硬膜下积液的早期诊断[J].重庆医科大学学报,0,():
婴儿化脓性脑膜炎并发硬膜下积液的早期诊断
Early diagnosis of purulent meningitis complicated with subdural effusion
DOI:
中文关键词:  化脓性脑膜炎  硬膜下积液  早期诊断
英文关键词:purulent meningitis  subdural effusion  early diagnosis
基金项目:
作者单位E-mail
蓝明平 重庆医科大学附属儿童医院 372847659@qq.com 
蒋莉  dr-jiangli@126.com 
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中文摘要:
      目的:分析婴儿化脓性脑膜炎并发硬膜下积液的临床特征,寻找可能早期提示发生硬膜下积液的指标。方法:收集2002年01月至2013年09月于重庆医科大学附属儿童医院诊断的化脓性脑膜炎并发硬脑膜下积液的婴儿共129例,随机选择同期住院的129例无硬膜下积液化脑婴儿临床资料作为对照,采用t检验/卡方检验/秩和检验及Logistic回归分析其临床特征。结果:婴儿化脓性脑膜炎并发硬膜下积液最常见的临床表现为:发热、惊厥、呕吐、前囟膨隆。两组资料比较提示:院外有发热、入院时前囟张力增高、瞳孔对光反射迟钝、意识障碍;入院后首次脑脊液蛋白、糖的水平以及脑脊液白细胞计数在两组间差异有统计学意义。多元Logistic回归分析提示:入院时前囟张力增高、入院后首次脑脊液糖<1.5 mmol/L、脑脊液白细胞计数>200×106 /L可能作为提示婴儿化脑并发硬膜下积液的指标。结论:婴儿化脓性脑膜炎并发硬膜下积液并无特异性临床表现,临床转归与辅助检查相结合是确诊的保证,而对入院时前囟张力增高、入院后首次脑脊液糖<1.5 mmol/L、脑脊液白细胞>200×106 /L的婴儿,应警惕化脑并发硬膜下积液。
英文摘要:
      Objective: To analyze the clinical features of children with purulent meningitis(PM) complicated with subdural effusion(SE), and search for the indicators of the early diagnosis for PM complicated with SE. Methods: A retrospective study was made of 258 children (129 children were diagnosed with PM complicated with SE,while the other randomly selected 129 children were PM only).T test / Chi-square test / Rank sum test and Logistic regression analysis were used to explore the clinical features.Results: The most common clinical features were:fever,convulsion,vomiting,and Bulging fontanelle,etc.The incidence of subdural effusions were closely correlated with the bulging fontanelle on admission,cerebrospinal fluid(CSF) glucose concentration on admission,and CSF WBC counts on admission.Conclusion: There is no specific clinical manifestations in SE,clinical outcomes and auxiliary examinations can guarantee the right diagnosis.Those infants may develope SE who have bulging anterior fontanelle on admission,CSF glucose concentration lower than 1.5 mmol/L,and CSF WBC count over than 200×106 /L.
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