Hodgetts T J, Brett A, Castle N
Accident and Emergency Department, Frimley Park Hospital NHS Trust, Camberley, Surrey, UK.
J Accid Emerg Med. 1998 Mar;15(2):72-6. doi: 10.1136/emj.15.2.72.
Meningococcal disease is a fulminant infection with an overall mortality of 8%. Mortality is significantly increased with meningococcal septicaemia, particularly when there has been a delay in the diagnosis. The trend from 1985 to 1995 has been an increase in incidence of this disease, and the relative importance of meningococcal disease has also increased following a fall in the incidence of invasive Haemophilus influenzae disease with childhood immunisation. The management of such cases can be complex and time critical. Patients with meningococcal septicaemia often require aggressive resuscitation, including airway support, intravenous colloid, and parenteral antibiotics; hypoglycaemia is also commonly seen, and inotropes may be needed to support the circulation. We examine the treatment strategies in the early management of meningococcal disease and provide an algorithm for use by ambulance personnel, general practitioners, accident and emergency clinicians, and paediatricians. The objective of this algorithm is to ensure that an optimally resuscitated patient is delivered to the definitive care facility.
脑膜炎球菌病是一种暴发性感染，总体死亡率为8%。脑膜炎球菌败血症会显著增加死亡率，尤其是在诊断出现延误时。1985年至1995年期间，这种疾病的发病率呈上升趋势，随着侵袭性流感嗜血杆菌疾病在儿童免疫接种后发病率下降，脑膜炎球菌病的相对重要性也有所增加。此类病例的处理可能很复杂且时间紧迫。患有脑膜炎球菌败血症的患者通常需要积极复苏，包括气道支持、静脉输注胶体液和肠外抗生素；低血糖也很常见，可能需要使用血管活性药物来维持循环。我们研究了脑膜炎球菌病早期处理中的治疗策略，并提供了一种供救护人员、全科医生、急诊临床医生和儿科医生使用的算法。该算法的目的是确保将复苏优化后的患者送至最终护理机构。
