化腦雙語袁寶莉ppt課件-資料下載頁
2025-05-12 06:39本頁面
【正文】 rognosis, the earlier diagnosis and the earlier treatment are very important. A child with rapidly progressing disease of less than 24 hr duration, in the absence of increased ICP, should receive antibiotics at once after an LP is performed. If there are signs of increased ICP or focal neurologic findings, antibiotics should be given without performing an LP. Increased ICP should be treated simultaneously. 治療原則 (1) 選擇抗生素原則 ? 早期足量 ? 有效殺菌劑 ? 易通過血腦屏障 ? 療程足 治療原則 (2) 抗生素治療 ?肺炎球菌 青霉素、氯霉素、三代頭孢菌素 ?流感桿菌 氨芐西林、三代頭孢菌素、氯霉素 療程 1014天 ?腦膜炎球菌 青霉素、三代頭孢菌素 療程 7天 ?金黃色葡萄球菌 耐酶青霉素、萬古霉素、利福平 ?大腸桿菌腦膜炎 三代頭孢、哌拉西林、氨基甙類 療程 21天 Supportive care Repeated medical assessments of patients with PM are essential to identify early signs of cardiovascular, CNS, and metabolic plications, such as pulse rate, blood pressure, respiratory rate, pupillary reflexes, level of consciousness, motor strength, cranial nerve signs, and evaluation for seizures. Maintain the balances of fluids, electrolytes, and plasma osomotic pressure. Corticosteroids Rapid killing of bacteria releases toxic cell products after cell lysis that precipitates the cytokinemediated inflammatory response result in edema formation and neurologic injury. Protein and fibrous effusion may result in fibrosis and Hydrocephalus due to interfering absorption of CSF. The corticosteroids can limit production of inflammatory mediators and fibrosis. 治療原則 (3) ? 腎上腺皮質(zhì)激素 ? 對癥治療、支持治療 降溫 降顱壓 20％甘露醇、速尿 止痙 魯米那、安定 治療原則 (4) ? 并發(fā)癥治療 硬膜下積液 穿刺放液、外科 腦室炎 引流、腦室內(nèi)局部抗生素應(yīng)用 [小結(jié) ] 小兒化腦常見致病菌。 小兒化腦臨床特點。 化腦腦脊液變化特點。 選用敏感抗生素，掌握好劑量及給 藥方式。
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