分析美罗培南对新生儿化脓性脑膜炎的临床治疗价值
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摘要
目的 于新生儿化脓性脑膜炎患儿中应用美罗培南实施治疗,分析其治疗效果。方法 从2014年3月—2017年8月结束,在该院选取30例新生儿化脓性脑膜炎患儿纳入研究,作为研究对象;依照均匀分组原则划分为2组,即对照组和观察组,每组各15例,对照组应用头孢曲松钠实施治疗,观察组联合应用美罗培南和头孢曲松钠实施治疗。观察比较两组患者的治疗效果以及不良反应(肾损伤、皮疹、呕吐、腹泻)发生情况。结果 观察组的治疗总有效率为93.33%,显著高于对照组的73.33%,差异有统计学意义(χ~2=6.789,P<0.05);观察组的细菌清除率为93.33%,显著高于对照组的66.67%,差异有统计学意义(χ~2=3.789,P<0.05);观察组的不良反应发生率为16.00%,显著高于对照组的36.00%,差异有统计学意义(χ~2=4.534,P<0.05);观察组的止惊时间为(1.14±0.23)d,颅内压降低时间为(2.12±0.42)d,脑膜刺激征消失时间为(5.14±0.22)d,退热时间为(1.14±0.22)d,意识状态恢复正常时间为(5.14±0.15)d,显著低于对照组的(2.25±0.55)d、(3.43±1.26)d、(6.25±1.55)d、(2.25±0.52)d、(6.25±1.52)d,差异有统计学意义(t=7.211 2,3.820 0,2.746 0,7.613 9,2.814 6,P<0.05);观察组治疗后脑脊液白细胞计数为(8.57±1.22)×10~9/L,显著低于对照组的(12.73±4.55)×10~9/L,差异有统计学意义(P<0.05)。结论 于新生儿化脓性脑膜炎患儿中应用美罗培南实施治疗的效果显著,其安全性强且细菌清除率高,可以明显缩短止惊时间,明显缩短脑膜刺激征消失时间,明显缩短颅内压降低时间,明显缩短退热时间及意识状态恢复正常时间,脑脊液白细胞计数减少,可获得显著效果,值得在临床中广泛推广应用。
Objective Meropenem was used in the treatment of neonatal purulent meningitis, and its therapeutic effect was analyzed.Methods From March 2014 to August 2017, 30 cases of neonatal purulent meningitis were selected as the research object in our hos-pital. According to the principle of uniform grouping, they were divided into two groups: control group and observation?group, with 15 cases in each group. The control group was treated with?ceftriaxone sodium, while the observation group was treated with meropenem and ceftriaxone sodium.?Results The total effective rate of the observation group was 93.33%, which was significantly higher than that of the control group 73.33%, with statistically significant difference(χ~2=6.389, P<0.05). The bacterial clearance rate of?the observation group was 93.33%, which was significantly higher than that of the control group 66.67%, with statistically significant difference( χ~2=4.534, P<0.05). The incidence of adverse reactions of?the observation group was 16.00%, which was significantly higher than that of the control group 36.00%, with statistically significant difference(χ~2=6.381, P<0.05). In observation group, the anticonvulsive time was(1.14±0.23) d, the intracranial pressure reduction time was(2.12±0.42) d, the meningeal irritation disappearance time was(5.14±0.22)d, the antipyretic time was(1.14±0.22) d, and the recovery time of consciousness was(5.14±0.15) d, which were significantly lower than those of control group(2.25±0.55) d,(3.43±1.26) d,(6.25±1.55) D.(2.25±0.52) d,(6.25±1.52) d, with statistically significant difference(t=7.2112, 3.8200, 2.7460, 7.6139, 2.8146, P<0.05). After treatment, the white blood cell count in cerebrospinal fluid of the observation group was(8.57±1.22)×10~9/L, which was significantly lower than that of the control group(12.73±4.55)×10~9/L, with statistically significant difference(P<0.05). Conclusion The application of meropenem in the treatment of neonatal purulent meningitis has a remarkable effect. It is safe and has a high bacterial clearance rate. It can shorten the time of arrest, the time of disappearance of meningeal irritation sign, the time of reduction of intracranial pressure, and the time of fever abatement and recovery of consciousness,and decrease the white blood cell count in cerebrospinal fluid. As a result, it is worth popularizing and applying widely in clinic.
Objective Meropenem was used in the treatment of neonatal purulent meningitis, and its therapeutic effect was analyzed.Methods From March 2014 to August 2017, 30 cases of neonatal purulent meningitis were selected as the research object in our hos-pital. According to the principle of uniform grouping, they were divided into two groups: control group and observation?group, with 15 cases in each group. The control group was treated with?ceftriaxone sodium, while the observation group was treated with meropenem and ceftriaxone sodium.?Results The total effective rate of the observation group was 93.33%, which was significantly higher than that of the control group 73.33%, with statistically significant difference(χ~2=6.389, P<0.05). The bacterial clearance rate of?the observation group was 93.33%, which was significantly higher than that of the control group 66.67%, with statistically significant difference( χ~2=4.534, P<0.05). The incidence of adverse reactions of?the observation group was 16.00%, which was significantly higher than that of the control group 36.00%, with statistically significant difference(χ~2=6.381, P<0.05). In observation group, the anticonvulsive time was(1.14±0.23) d, the intracranial pressure reduction time was(2.12±0.42) d, the meningeal irritation disappearance time was(5.14±0.22)d, the antipyretic time was(1.14±0.22) d, and the recovery time of consciousness was(5.14±0.15) d, which were significantly lower than those of control group(2.25±0.55) d,(3.43±1.26) d,(6.25±1.55) D.(2.25±0.52) d,(6.25±1.52) d, with statistically significant difference(t=7.2112, 3.8200, 2.7460, 7.6139, 2.8146, P<0.05). After treatment, the white blood cell count in cerebrospinal fluid of the observation group was(8.57±1.22)×10~9/L, which was significantly lower than that of the control group(12.73±4.55)×10~9/L, with statistically significant difference(P<0.05). Conclusion The application of meropenem in the treatment of neonatal purulent meningitis has a remarkable effect. It is safe and has a high bacterial clearance rate. It can shorten the time of arrest, the time of disappearance of meningeal irritation sign, the time of reduction of intracranial pressure, and the time of fever abatement and recovery of consciousness,and decrease the white blood cell count in cerebrospinal fluid. As a result, it is worth popularizing and applying widely in clinic.
引文
[1]邓彩艳,金二丽,胡彩霞.神经节苷脂联合美罗培南治疗新生儿化脓性脑膜炎后临床疗效分析[J].中国实用神经疾病杂志,2016(16):132-133.
[2]黄妮娜.美罗培南在小儿化脓性脑膜炎临床治疗中的应用分析[J].陕西医学杂志,2017(8):1130-1131.
[3]谢毅,王锦,刘志芳,等.研究美罗培南治疗新生儿细菌性脑膜炎的临床效果[J].黑龙江医药,2018(4):797-798.
[4]袁泉,郑帅,张祎.美罗培南联合醒脑静注射液治疗小儿化脓性脑膜炎的临床研究[J].北方药学,2018(7):61.
[5]乔凌燕,刘玉圣,刘颖.高压氧联合美罗培南治疗小儿化脓性脑膜炎的治疗效果以及安全性研究[J].检验医学与临床,2016(20):2968-2969.
[6]张文珊.美罗培南静脉注射联合吸入在呼吸机相关性肺炎疾病治疗中的效果观察[J].黑龙江医药,2017(2):335-337.
[7]文艺.神经节苷脂联合美罗培南对新生儿化脓性脑膜炎神经系统后遗症发生率的影响[J].临床研究,2018,26(3):101-102.
[8]马小云,李昭,王雪君,等.鞘内注射万古霉素并地塞米松治疗小儿难治性化脓性脑膜炎的疗效研究[J].重庆医学,2017,46(22):3070-3072,3076.
[9]李晶,许邦礼.头孢曲松钠联合地塞米松对新生儿化脓性脑膜炎血清S-NSE水平的影响[J].山西职工医学院学报,2018,28(5):72-74.
[10]潘海涛.地塞米松辅助抗感染治疗对小儿难治性化脓性脑膜炎的疗效分析[J].中华医院感染学杂志,2018,28(14):2189-2192.
[2]黄妮娜.美罗培南在小儿化脓性脑膜炎临床治疗中的应用分析[J].陕西医学杂志,2017(8):1130-1131.
[3]谢毅,王锦,刘志芳,等.研究美罗培南治疗新生儿细菌性脑膜炎的临床效果[J].黑龙江医药,2018(4):797-798.
[4]袁泉,郑帅,张祎.美罗培南联合醒脑静注射液治疗小儿化脓性脑膜炎的临床研究[J].北方药学,2018(7):61.
[5]乔凌燕,刘玉圣,刘颖.高压氧联合美罗培南治疗小儿化脓性脑膜炎的治疗效果以及安全性研究[J].检验医学与临床,2016(20):2968-2969.
[6]张文珊.美罗培南静脉注射联合吸入在呼吸机相关性肺炎疾病治疗中的效果观察[J].黑龙江医药,2017(2):335-337.
[7]文艺.神经节苷脂联合美罗培南对新生儿化脓性脑膜炎神经系统后遗症发生率的影响[J].临床研究,2018,26(3):101-102.
[8]马小云,李昭,王雪君,等.鞘内注射万古霉素并地塞米松治疗小儿难治性化脓性脑膜炎的疗效研究[J].重庆医学,2017,46(22):3070-3072,3076.
[9]李晶,许邦礼.头孢曲松钠联合地塞米松对新生儿化脓性脑膜炎血清S-NSE水平的影响[J].山西职工医学院学报,2018,28(5):72-74.
[10]潘海涛.地塞米松辅助抗感染治疗对小儿难治性化脓性脑膜炎的疗效分析[J].中华医院感染学杂志,2018,28(14):2189-2192.