摘要
目的探讨儿童结核性脑膜炎(TBM)的临床特点,以提高临床早期诊断和治疗水平。方法回顾性分析2008年1月至2010年12月该院收治的170例TBM患儿的临床特征及实验室检查。结果全组病例中,161例有结核中毒症状,162例有神经系统症状、体征。影像学检查胸部X线片、头颅CT、头颅磁共振异常率分别为78%、90%、89%。脑脊液常规及生化检测分别有143例及146例表现异常,但脑脊液生化检测仅36例有典型表现,159例脑脊液病原学检查有病原学证据者为71例。Ⅰ型TBM治疗有效率为100%,Ⅱ、Ⅲ型TBM有效率分别为96%、83%,Ⅳ型TBM有效率最低(仅为38%),而且恶化或病死率最高。结论儿童TBM临床表现复杂,早期诊断且正规抗结核治疗是提高治愈率、降低病死率的关键。
Objective To summarize the clinical features of tuberculous meningitis （TBM） in the children, and to improve early diagnosis and treatment. Methods 170 cases of TBM in our hospital from Jan. 2008 to Dec. 2010 were retrospectively analyzed. Results In all cases, 161 cases combined with TB symptoms, 162 cases combined with neurological symptoms and sign. The abnor- mal rates tested by chest X rays,CT scan and MRI were 78% ,90% and 89%o ,respectively. 143 cerebrospinal fluid routine and 146 biochemical test respectively had abnormal performance, but only 36 cases had typical performance in eerebrospinal biochemical, Out of 159 cases, 71 cases had etiological evidence in pathological examination. The effective rates were 100% in type Ⅰ , 96% in type Ⅱ and 83% in type Ⅲ ,it was least in type Ⅳ（only 38%）which had the highest mortality. Conclusion Children with TBM have complex manifestations,the keys to increase the cure rate and reduce mortality are early diagnosis and regular antitubercular treat- ment.
出处
《重庆医学》
CAS
CSCD
北大核心
2012年第31期3273-3275,共3页
Chongqing medicine
关键词
结核
脑膜
儿童
临床表现
tuberculosis, meningeal
children
clinical characteristic
