儿童细菌脑膜炎的严重程度和疾病在诊断前的持续时间
T Kilpi1, M Anttila, M J Kallio
1Children's Hospital, University of Helsinki, Finland.
Lancet (London, England)
|August 17, 1991
概括
儿童细菌性脑膜炎 (BM) 的快速诊断至关重要. 然而,在入院前的更长的疾病持续时间与儿童的更好的临床结果相关,这表明潜伏的疾病模式可能会导致不可避免的诊断延迟.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 儿童细菌性脑膜炎 (BM) 的快速诊断被认为是有利结果的必要条件.
- 医院入院前的疾病持续时间和儿科BM的疾病严重程度之间的关系需要进一步调查.
研究的目的:
- 调查住院前疾病持续时间与儿童细菌脑膜炎临床严重程度之间的关联.
主要方法:
- 一项前性研究收集了来自18家芬兰儿科医院 (1984-1989) 的286名培养阳性BM儿童的数据.
- 病例被分为短史 (≤24小时),中间史 (>24小时至≤48小时) 和长史 (>48小时) 组.
- 临床严重程度使用包括意识水平,,脑流蛋白,格拉姆染色,血培养,CRP和尿液等变量进行评估.
主要成果:
- 与病史较长 (>48小时) 的儿童相比,患病时间较短 (≤48小时) 的儿童的临床状况明显较差.
- 在意识,发作,脑液蛋白质,积极的脑液格拉姆染色,积极的血液培养 (H. influenzae),血清CRP和尿液方面观察到更糟糕的结果.
- 这些差异独立于致病生物体,性别,年龄或先前的抗微生物药物使用.
结论:
- 在儿科细菌性脑膜炎的入院前,疾病持续时间较长,矛盾的是与更好的临床状况有关.
- 肌肉病的潜伏发作可能导致不可避免的诊断延迟,可能会产生医疗法律影响.
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