62例新生儿化脓性脑膜炎的临床及病原学分析.doc

62例新生儿化脓性脑膜炎的临床及病原学分析 王海磊1，马　娜2（1.河南大学淮河医院，河南开封 475000；2.开封市儿童医院，河南开封 475000） 摘要 目的 探讨新生儿化脓性脑膜炎的病原学特点及临床治疗方法。方法 选取河南大学淮河医院新生儿科2012年5月至2014年5月收治的62例新生儿化脓性脑膜炎，所有患儿均在入院时未应用抗生素前进行血培养，入院48小时内进行脑脊液检查，根据病原学检查合理应用抗生素。结果 62例化脓性脑膜炎患儿中有32例血培养呈阳性，其中大肠埃希菌10例，金黄色葡萄球菌1例，表皮葡萄球菌5例，溶血葡萄球菌16例。62例脑脊液培养中有2例阳性，大肠埃希菌1例，金黄色葡萄球菌1例。患儿的平均住院时间32.30±4.98天，均临床治愈，无死亡病例，致残率9.67%。结论 新生儿化脓性脑膜炎病原菌主要为大肠埃希菌、葡萄球菌，早诊断、早治疗，合理选用抗生素是减少致残率、死亡率的关键。 关键词 新生儿；化脓性脑膜炎；病原学 Analysis of clinical and etiology in 62 neonates with purulent meningitis WANG Hai-lei1， MA　Na2（1.Huaihe Hospital of Henan University， Kaifeng 475000，China；2 Kaifeng Children’s Hospital，Kaifeng 475000，ChinaAbstract: Objective To investigate the neonatal purulent meningitis pathogenic characteristics and treatment methods. Methods 62 cases of purulent meningitis in children from May 2012 to May 2014 were treated in Huaihe Hospital of Henan University neonatal. All of the patients were treated with culture of blood and cerebrospinal fluid culture and culture results analysis, reasonable application of antibiotics according to pathology. Results 32 of 62 cases of children with purulent meningitis were with positive blood culture and In those positive test results of children 10 cases of Escherichia coli, 1 strains of Staphylococcus aurous, 5 cases of Staphylococcus epidermidis,16 cases of hemolytic staphylococci. Cerebrospinal fluid culture was positive in 2 cases, 1 cases of Escherichia coli, 1 strains of Staphylococcus aurous. The average hospitalization time of the children was 32.30 ± 4.98 days. They were clinically cured, no death, disability rate 9.67%.Conclusion The pathogen of neonatal purulent meningitis mainly Escherichia coli, Staphylococcus aurous. Early diagnosis and early treatment, rational use of antibiotics is the key to reduce morbidity and mortality. [Key words] Neonates；Purulent meningitis；Etiology 2012年5月至2014年5月收治的62例新生儿化脓性脑膜炎，现报道如下。 1 资料和方法 1.1 一般资料 我院2012年5月至2014年5月份收治的新生儿化脓性脑膜炎患儿62例，胎龄均为37-42周，平均体重3.25±1.08kg，起病时间：年龄最小3天，最