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化脓性脑膜炎 Purulent Meningitis. 讲课主要内容 ● 病因学 ● 病理与发病机理 ● 临床表现 ● 诊断与鉴别诊断 ● 并发症及后遗症 ● 治疗. 对本病的几点基本认识. ● 由化脓性细菌引起的急性颅内感染,病 变部位主要在脑膜(蛛网膜和软脑膜); ● 临床主要表现发热、反复惊厥、意识丧 失、颅压增高、脑膜刺激征,及脓性脑脊 液; ● 迄今病死率( 5 % ~ 15 %)和后遗症发生率 高,幸存者中 1/3 有后遗症; ● 主要发生于婴幼儿,越年幼预后越严重。. - PowerPoint PPT Presentation
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PurulentMeningitis
5~15 1/3
2/3
- -
- -
1093 1/3 22% 9.1% 1/3 40123.2%21.4%37.9%5.7%5.5%6.3% __
3
Ig
BBB 31- -
3 1 IgM 0 50% 70% IgG 60%70% 60%
- -
;
- -
1 1/22/3
3 - -
Kernigs Brudzinski
Grams
- -
(mmH2O (/106Pandy (g/L (mmol/L 1801.76Kpa 10 0.2 0.42.84.5 110120mmol/L ,++ ++++ +++ 1 ++ + +++ 1 +
CSF WBC
CSF WBC
CSF WBC
33
- -
CSF CSFPPD
2>40mg%
46 1 10% 50% 30%45%9% - -
1 2CSF 3 4B 5- -
CSF B/ ,CSF
MR - -
CSF
- -
:: () Cefotaxime 200mg/kgd4 BBB24hCSF Ceftriaxone 100mg/kgd12 A
- -
+ 3040U/kgd34 80100mg/kgd34Ceftazidime 50100mg/ kgd 3 Cefuroxime 50100mg/ kgd 3 CSF- -
- - 7 1014 710
IIIII 100mg/kgd3450~60mg/ kgd 4 3
+ 3B G 2~3
- -
60~80ml/kgd 20%1~2g/kgq.4~6.h
0.3~0.5mg/kgd - -
15ml/30ml3~4
- -
3