Abstract：【Objective】 To investigate the risk factors of hydrocephalus in neonates with purulent meningitis. 【Methods】 The clinical data of 173 neonates with purulent meningitis admitted to our hospital from February 2019 to April 2021 were analyzed retrospectively. They were divided into hydrocephalus group (n=55) and non hydrocephalus group (n=118) according to whether hydrocephalus occurred. The demographic data, clinical data, laboratory test results and intracranial magnetic resonance examination results of the children were collected. Logistic regression analysis was used to analyze the risk factors affecting the occurrence of hydrocephalus, and the predictive value of hydrocephalus was evaluated by drawing a risk model ROC curve. 【Results】 Hydrocephalus occurred in 55 of 173 children with meningitis (31.79%). The clinical symptoms of children in hydrocephalus group were respiratory failure and convulsion, and the count of white blood cells in cerebrospinal fluid was>20×106/L, CSF glucose ＜2.2 mmol/L, CSF protein ＞ 1.5 g/L. The proportion of cerebrospinal fluid culture positive and imaging examination showed that leukomalacia, small white matter lesions, intraventricular hemorrhage, and purulent brain abscess were significantly higher than those of children without hydrocephalus (P<0.05). Logistic regression analysis showed that CSF glucose<2.2 mmol/L and CSF white blood cell count>20×106/L, CSF protein ＞1.5 g/L. Positive cerebrospinal fluid culture and intracranial magnetic resonance imaging showed small lesions in white matter, intraventricular hemorrhage, and purulent brain abscess were risk factors for hydrocephalus in children with purulent meningitis (P<0.05). The above risk factors were used to establish a prediction model by stepwise regression method. The ROC curve analysis showed that the area under the curve of the prediction model was 0.881, with high prediction value. 【Conclusion】 The risk model of neonatal purulent meningitis established by clinical symptoms, laboratory tests and intracranial MRI findings has a good predictive value for hydrocephalus.
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2023, Vol. 40 
