【摘要】 目的总结儿童肺炎链球菌脑膜炎(PM)临床资料。方法回顾性分析我院41例PM的临床资料。结果 30例来自农村;男:女为26:15;≤2岁多见;多在冬春季发病;10例患儿有高危因素。临床症状以发热、头痛、呕吐、惊厥、意识障碍为主,体征以颈抵抗、前囟紧张多见;白细胞、中性粒细胞百分比、C-反应蛋白、降钙素原、乳酸脱氢酶升高,部分有贫血及血小板减少,所有患儿首次脑脊液白细胞均升高,脑脊液蛋白升高、糖降低常见。分离菌株药物敏感性分析发现耐药率高。经治疗后10例死亡,19例出现并发症。结论 PM好发于≤2岁、来自农村、有高危因素的男童;大多临床表现典型,脑脊液改变明显,炎症指标升高,肺炎链球菌耐药问题严重,病死病残率高。更多还原

【Abstract】 Objective To summarize the clinical data of children with pneumococcal meningitis. Methods Clinical datas of41 hospitalized children with pneumococcal meningitis were retrospectively analyzed. Results 30 patients were from rural areas.The ration of male to female was 1.73. Most children were less than 2 years old and occurred in winter and spring. Ten children had predisposing factors. The main clinical symptoms were fever, headache, vomiting, convulsion and conscious disturbance. The signs were neck resistance and tense anterior fontanelle. Peripheral blood leukocyte, percentage of neutrophils, C-reactive protein,procalcitonin and lactate dehydrogenase were increased, some of them have anemia and thrombocytopenia. The leukocyte counts and of the first cerebrospinal fluid in all children were elevated, the increased protein and decreased sugar level of cerebrospinal fluid were common. High drug-resistance rate was showed by drug susceptibility analysis of isolated strains. There were still 10 deaths and 19 cases with complications after active treatment. Conclusion PM was common in boys under 2 years old, from rural areas and with high-risk factors. Most of them had typical clinical manifestations, changes in cerebrospinal fluid were obvious, inflammatory indicators were increased. Drug resistance of Streptococcus pneumoniae was serious. The rates of mortality and disability were high.更多还原