婴儿结核性脑膜炎与家庭接触感染的临床特点及相关分析

目的对家庭成员为传染源与婴儿结核性脑膜炎的相关性及其早期诊断进行临床分析。方法对我院近8年收治的有结核病接触史的婴儿结核性脑膜炎患儿33例的早期临床特点及疗效进行分析。并以同期收治的1～3岁幼儿结核性脑膜炎患者作对照。结果婴儿结核性脑膜炎患儿有家庭成员结核病接触者发病率为48.5%,而对照组仅为7.7%。婴儿结核性脑膜炎患儿有卡介苗接种占75.8%,但疗效欠佳,治愈率仅36.4%;后遗症发生率36.4%,两项与对照组比效有显著性差异(p<0.05)。结论家庭密切接触是婴儿患结核性脑膜炎的高危因素,其父母为主要传染源,值得高度重视。可以把有结核病接触史、发热、意识障碍、抽搐等临床特点作为判断婴儿结脑疑似病例的依据。

THE CORRELATION BETWEEN TUBERCULOUS MENINGITIS AND HOUSEHOLD CONTACT IN INFANTS AND ITS CLINICAL FEATURES

Objective To analyze early diagnosis of tuberculous meningitis in infant and the relativity between infant tuberculous meningitis and their family members as source of infection.Methods We analyzed the early clinical features and curative effect of 33 cases of infants with tuberculous meningitis whose family members had pulmonary tuberculosis in our hospital in recent eight years,and 1-3 years old infants with tuberculous meningitis in our hospital in the same period as control group.Results Incidence tuberculous meningitis in infants whose family members had pulmonary tuberculosis was 48.5%,but it is only 7.7% in control group.BCG vaccine were inoculated in 75.8 percents infant with tuberculous meningitis,but poor curative effect,and the cure rate is only 36.4%,and the sequela rate was 36.4%.There are significant differences between the two groups(p<0.05).Conclusion Family close contact is the risk factor of tuberculous meningitis in baby,and the parents is the main infection source.It deserves our great attention.Clinical characteristics,including contact history,fever,disorder of consciousness,convulsions and so on,have meaning in early diagnosis of tuberculous meningitis.