125例老年性结核性脑膜炎诊断及治疗分析

目的总结老年性结核性脑膜炎(结脑)的诊断方法。方法结合临床表现、脑脊液、影像学检查以及免疫学,分析125例老年性结脑临床资料。结果结合临床症状、体征、脑脊液、影像学及免疫学,125例患者临床诊断为结核性脑膜炎,给予诊断性抗结核治疗,大部分病例好转出院。结论老年性结脑发病缓慢,早期临床症状不典型,诊断困难,误诊率及死亡率高。对结脑的患者均应反复行脑脊液及头部核磁共振检查,排除其他颅内感染性病变、脑血管疾病及肿瘤性疾病,尽早做诊断性抗结核治疗。结核性脑膜炎是中枢神经系统的重症结核病。目前,随者人口老龄化,老年结核性脑膜炎患者呈逐年增多趋势,老年患者因其特殊体质关系,导致临床症状不典型、并发症多、误诊率高,治疗困难。使其病死率及后遗症发生率高。

Diagnosis and treatment analysis of senile patients with tuberculous meningitis

Objective To summarize the diagnostic methods of senile patients with tuberculous meningitis. Methods Combined with clinical manifestations, cerebrospinal fluid, sings, imaging examinations and immunology, the clinical data of tuberculous meningitis was analyzed in 125 patients. Results Combined with clinical manifesta- tions, eerebrospinal fluid, sings, imaging examinations and immunology, 125 patients were diagnosed as tuberculous meningitis by clinical methods, and given the diagnostic TB-treatment. Finally, most patients were improved and dis- charged. Conclusion Senile tuberculous meningitis fell ill slowly, with early atypical clinical symptoms, difficult diagnosis, and high rates of misdiagnosis and mortality. The patients with tuberculous meningitis should be repeatedly punctured cerebrospinal fluid and made magnetic resonance imaging.