目的 探讨地塞米松联合美罗培南治疗小儿化脓性脑膜炎的临床疗效。方法 选取2014年11月-2016年3月在成都市妇女儿童中心医院就治的化脓性脑膜炎患儿86例，随机分为对照组（43例）和治疗组（43例）。对照组患儿静脉注射注射用美罗培南，20 mg/kg，2次/d。治疗组在对照组的基础上静脉滴注地塞米松磷酸钠注射液，前3 d剂量为15 mg/d加入5%的葡萄糖注射液250 mL，根据症状改善情况调整剂量，最后剂量为10 mg/d。两组患儿均治疗14 d。评价两组患者临床疗效，同时比较治疗前后两组患儿脑脊液和外周血中C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、硫化氢（H₂S）和一氧化氮（NO）水平，以及症状和体征恢复时间。结果 治疗后，对照组临床总有效率为83.72%，显著低于治疗组的93.02%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组脑脊液和外周血中CRP、TNF-α、H₂S和NO水平均显著降低，同组比较差异具有统计学意义（P<0.05）；且治疗后治疗组上述因子水平均低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组脑脊液和外周血中白细胞恢复时间以及体温恢复时间和意识恢复时间明显短于对照组，两组比较差异具有统计学意义（P<0.05）。结论 地塞米松联合美罗培南治疗小儿化脓性脑膜炎临床效果显著，可使患儿尽快恢复正常体温和意识，具有一定的临床推广应用价值。

Objective To investigate the efficacy of dexamethasone combined with meropenem in treatment of purulent meningitis in children. Methods Children (86 cases) with purulent meningitis in Chengdu Women and Children's Center Hospital from November 2014 to March 2016 were randomly divided into control (43 cases) and treatment (43 cases) groups. Children in the control group were iv administered with Meropenem for injection, 20 mg/kg, twice daily. Children in the treatment group were iv administered with Dexamethasone Sodium Phosphate Injection on the basis of the control group, the dosage for the first three days was that 15 mg/d added into 5% glucose injection 250 mL, and adjust dosage according to symptom improvement, the final dose was 10 mg/d. Children in two groups were treated for 14 d. After treatment, clinical efficacy was evaluated, and the CRP, TNF-α, H₂S, and NO levels in the cerebrospinal fluid and peripheral blood, and the recovery time of symptoms and signs in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 83.72%, which was significantly lower than 93.02% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the CRP, TNF-α, H₂S, and NO levels in the cerebrospinal fluid and peripheral blood in two groups were significantly decreased, the difference was statistically significant in the same group (P<0.05). And these factor levels were lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the leukocyte recovery time in the cerebrospinal fluid and peripheral blood, and body temperature and consciousness recovery time in the treatment group were significantly shorter than those in the control group, with significant difference between two groups (P<0.05). Conclusion Dexamethasone combined with meropenem has significant clinical effect in treatment of purulent meningitis in children, can recover normal body temperature and consciousness as soon as possible, which has a certain clinical application value.