Title Analiza likvora u dijagnostici meningitisa neurokirurških bolesnika
Title (english) Cerebrospinal fluid analysis in the diagnosis of meningitis in neurosurgical patients
Author Petra Knežević
Mentor Dinko Tonković (mentor)
Committee member Slobodan Mihaljević (predsjednik povjerenstva)
Committee member Ante Sekulić (član povjerenstva)
Committee member Dinko Tonković (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Anaesthesiology, Resuscitation and Intensive Care in Surgical Specialities) Zagreb
Defense date and country 2020-07-17, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Intensive Care
Abstract UVOD: Meningitis nakon neurokirurških postupaka rijetka je, ali vrlo ozbiljna komplikacija koja zahtjeva trenutno djelovanje. Profilaktička primjena antibiotika, krvarenje i upala u SŽS-u te nedovoljna specifičnost i osjetljivost kliničkih znakova u takvih pacijenata otežava postavljanje dijagnoze. ----- CILJ RADA: Cilj rada ovog istraživanja je procijeniti dijagnostičku vrijednost citoloških, biokemijskih i mikrobioloških parametara nalaza analize likvora. ----- MATERIJAL I METODE: U ovoj
... More retrospektivnoj presječnoj studiji, nakon provođenja kriterija uključivanja i isključivanja, bilo je uključeno 40 pacijenata koji su boravili na Odjelu za anesteziologiju i intenzivno liječenje neurokirurških bolesnika, od toga 19 žena (47,5%) i 21 muškarac (52,2%), prosječne dobi 60,73 godina sa standardnom devijacijom 16,19. Prikupljani i analizirani su podaci iz elektroničke baze podataka, uvidom u povijest bolesti, laboratorijske pretrage i sestrinske liste. Podaci su statistički obrađeni u programu IBM SPSS Statistics. -----
REZULTATI: Od kliničkih znakova, temperatura je bila povišena tek u 45% pacijenata, no uočena je značajna (p=0,026) razlika u vrijednostima temperature neposredno nakon operacije i u trenutku najlošijih nalaza likvora. Mikrobiološki nalazi su bili pozitivni u svega 13,33%. Uočena je leukocitoza u većine pacijenata (95%) sa značajnom (p=0,008) razlikom u razini leukocita u odnosu na prvi postoperativni nalaz. Formule za korekciju broja leukocita smanjile su postotak nalaza koji se smatraju leukocitozom, ali su dovele do značajne (p=0,006 i p=0,003) razlike od prvog nalaza nakon operacije. Dokazana je i značajna (p=0,003) razlika u razinama CRP u krvi. Snižena glukoza, povišeni proteini i laktat javljali su se u većine pacijenata, no bez značajne razlike u vrijednostima između ta dva nalaza. ----- ZAKLJUČAK: Klinički znakovi i mikrobiološka analiza likvora rijetko mogu pomoći pri
dijagnozi meningitisa u neurokirurških bolesnika. Od citoloških i biokemijskih parametara javljaju se leukocitoza, snižena glukoza, povišeni ukupni proteini i laktat u likvoru te leukocitoza i povišena razina CRP u krvi u većine pacijenata. Less
Abstract (english) INTRODUCTION: Postneurosurgical meningitis is a rare, but serious complication that requires rapid interventions. Prophylactic use of antibiotics, blood and inflammation in the CNS, insufficient specificity and sensitivity of clinical signs in such patients make diagnosis difficult. ----- AIM: To evaluate the diagnostic value of cytological, biochemical and microbiological parameters of cerebrospinal fluid analysis findings. ----- MATERIALS AND METHODS: This retrospective cross-sectional
... More study included 40 patients who stayed in the Neurosurgical intensive care unit. There were 19 women (47.5%) and 21 men (52.2%), mean age 60.73 years with standard deviation 16.19. Data from the electronic database (medical history, laboratory tests and nursing lists) were collected, analyzed and statistically processed in IBM SPSS Statistics. ----- RESULTS: Fever was present in only 45% of patients, but a significant (p = 0.026) difference in temperature values was observed immediately after surgery and at the time of the worst cerebrospinal fluid findings. Microbiological findings were positive in only 13.33%. Cerebrospinal fluid leukocytosis was observed in most patients (95%) with a significant (p = 0.008) difference in the level of leukocytes compared to the first postoperative finding. Leukocyte count correction formulas reduced the percentage of findings considered leukocytosis, but led to a significant (p = 0.006 and p = 0.003) difference in values from the first postoperative finding. A significant (p = 0.003) difference in blood CRP levels was also discovered. Hypoglycorachia, elevated protein and lactate concentrations were present in most patients, but without
significant differences in values between the two findings. ----- CONCLUSION: Clinical signs and microbiological analysis of cerebrospinal fluid can rarely help in the diagnosis of postneurosurgical meningitis. Leukocytosis, hypoglycorachia, elevated protein and lactate concentrations in the cerebrospinal fluid, leukocytosis and elevated CRP levels in the blood are often found in these patients. Less
Keywords
likvor
meningitis
neurokirurški pacijenti
Keywords (english)
cerebrospinal fluid
meningitis
neurosurgical patients
Language croatian
URN:NBN urn:nbn:hr:105:711132
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2021-04-12 09:33:01