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[新生儿细菌性脑膜炎:55例患儿长期预后的前瞻性研究]

[Neonatal bacterial meningitis: prospective study of the long-term outcome of 55 children].

作者信息

Jornada Krebs V L, De Albuquerque Diniz E M, Costa Vaz F A, Marques Dias M J, Takiguti C, Araújo Ramos J L

机构信息

Instituto da Criança, Universidade de São Paulo, Brasil.

出版信息

Arq Neuropsiquiatr. 1996 Mar;54(1):75-81.

PMID:8736149
Abstract

Fifty-five infants who presented bacterial neonatal meningitis were prospectively studied to analyze the frequency and the type of sequelae. All the infants were full term newborns. There were 38 boys and 17 girls; the age of disease onset varied from 3 to 28 days. The causative organism was represented mainly by enterobacteriae. The median time of follow-up was 5 years. The frequency of neurologic sequelae was 63.7%, represented mainly by neuropsychomotor development delay (58.2%), hydrocephaly (45.5%) and convulsions (34.5%). Severe motor abnormalities ocurred in 23.6% of children (quadriplegia, diplegia, hemiparesia and ataxia). Convulsions in the acute phase of the disease and the positive cerebrospinal fluid culture were highly associated to sequelae. The school performance, obtained in 25 children, showed presence of disabilities in 48% of cases, which were significantly associated to mental retardation.

摘要

对55例患细菌性新生儿脑膜炎的婴儿进行了前瞻性研究,以分析后遗症的发生率和类型。所有婴儿均为足月儿。其中男婴38例,女婴17例;发病年龄在3至28天之间。致病菌主要为肠杆菌科细菌。随访时间中位数为5年。神经后遗症的发生率为63.7%,主要表现为神经精神运动发育迟缓(58.2%)、脑积水(45.5%)和惊厥(34.5%)。23.6%的儿童出现严重运动异常(四肢瘫、双瘫、偏瘫和共济失调)。疾病急性期的惊厥和脑脊液培养阳性与后遗症高度相关。对25名儿童的学业表现进行评估,结果显示48%的病例存在残疾,这与智力发育迟缓显著相关。

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