 Wysłany: Nie 23:25, 27 Mar 2011 Temat postu: Auxiliary dexamethasone on acute bacterial meningi |
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| Auxiliary dexamethasone on acute prognosis of bacterial meningitis
CSF groups on day 4 review results in Table 3. Table 3 shows the quantitative observation group was higher CSF glucose, other indexes had no significant difference in meaning. 2. After treatment,tory burch, symptoms and signs completely disappeared time in the observation group (7.0 ± 1.  days, the control group (7.8 ± 2.2) days. No difference between the two groups was significant (1.643, P> 0.05). 3. Two groups of patients discharged from hospital day when the observation of 502 cases of Zhejiang Medicine 2001 Vol.23 No. 8 Wong Yuen top 3 groups 4 days after treatment in children with cerebrospinal fluid review the results of the comparison group was (14.1 ± 2.5) days, the control group (15.2 ± 3.1) days, no difference between the two groups was significant (1.613, P> 0.05). CSF examination at discharge observation group were normal, the normal control group 4o cases, abnormal in 1 case. 4. The incidence of complications and sequelae of treatment of complications of an Observation Unit 3, 9.68%, and subdural effusion in 2 cases, 1 case of cerebral hyponatremia; control group, 4 cases. Accounting for 9.75%. One subdural effusion in 2 cases, 2 cases of cerebral hyponatremia. No difference in complication rate between the two significant (z-0.16, P> 0.05). After 16 months after discharge follow-up, sequelae found in the observation group 2 patients (6.45%), including moderate hearing impairment and strabismus in 1 case; the control group】 sequelae occurred in 2 cases (29.27%), including 2 cases of mentally retarded epilepsy in 4 cases, 6 cases of severe hearing loss (Taiwan and strabismus l patients). The incidence of complications between the two there were significant differences (. = 4.52.P <0.05). Compared the two groups, after-effects relative risk 4.54. As the discussion continued strong development of effective antibiotics. Currently the treatment of acute bacterial meningitis has improved greatly effect the nervous system sequelae but still more .... How to prevent or control the incidence of complications, is a clinical need for attention. Significant because extensive meningeal inflammation, promote local tumor necrosis factor, interleukin 1, prostaglandin 2 and other cytokines, these cytokines mediated by the inflammatory reaction in the cerebrospinal fluid may continue to exist after sterile, leading to bacterial chronic inflammatory sequelae of meningitis】. Is generally believed that hormone treatment of bacterial meningitis is not as regular medication, only for shock or significant brain edema. Scholars [4,51 study confirmed bacterial meningitis in children with early use of dexamethasone to prevent the occurrence of complications, infants and children can significantly improve the prognosis of bacterial meningitis. The mechanism: a non-specific anti-inflammatory steroid, anti-drug and anti-allergic effects, can inhibit the inflammatory response and reduce the inflammatory exudate, to prevent adhesion; reduce capillary permeability, maintaining the integrity of blood-brain barrier; inhibited local allergic necrotic reaction; to reduce cerebrospinal fluid production and intracranial pressure; to improve cerebral blood flow; reduce the swelling of glial cells and edema; prevent hearing and hearing damage to the conduction system. Short-term use without significant side effects. This data also showed that dexamethasone and control groups in the disappearance of symptoms and signs of the time, conventional indicators of cerebrospinal fluid (other than sugar) in the recovery of cerebrospinal fluid culture was negative rate of complications were similar, indicating that the ground Dexamethasone does not improve acute bacterial meningitis in children with short-term effect. However, after dexamethasone, significantly reduced the incidence of complications, sequelae relative risk of 4.54, indicating that dexamethasone can improve secondary acute bacterial meningitis in children prognosis. Central nervous system caused by bacterial toxins as metabolic changes and inhibit the function of membrane carrying operation, the blood glucose transport to cerebrospinal fluid barrier; and the role of bacteria in the glycolysis of glucose into lactic acid led, resulting in children with bacterial meningitis CSF significantly reduced the sugar or disappear. But this data show that both groups 4 days after treatment, the observation group in the quantitative higher CSF glucose, which may have the anti-inflammatory dexamethasone, anti-drug and anti-allergic effect and affect glucose metabolism. I edited 19842742 Wang Mu Tong Song Name invited editor of 20 [10.392. |
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