高原地区儿童结核性脑膜炎临床特征及早期诊断探讨

目的探讨适合于高原地区儿童结核性脑膜炎的早期诊断和治疗标准。方法回顾性分析2004～2010年75例结核性脑膜炎患儿的资料,对其生活区域、临床资料等进行综合分析。结果 57例分布于平均海拔3400～4200 m的地区,其余18例分布于平均海拔1700～3500 m的地区;57例无卡介苗接种史;49例患儿发病早期头颅CT和磁共振检查呈阳性结果;合并Ⅰ型肺结核15例,Ⅱ型肺结核27例。治愈41例。好转自动出院29例,其中合并失语7例,癫痫9例,肢体瘫痪8例,智力低下5例。死亡5例。结论青藏高原牧业区是儿童结核性脑膜炎的高发地区,病死率和致残率也较高;探索实用的早期诊治标准,对有效降低致死率和致残率极为重要。

The Clinical Features of Tuberculous Meningitis in Children at Plateau and Discussion of the Early Diagnosis

Objective To find a method for the early diagnosis of tuberculous meningitis(TM)in children at high altitude.Methods Retrospectively reviewed 75 cases of TM during 2004 to 2010 in children at high altitude,and analysis their utility area,clinical data.Results 57 cases distributed in an average altitude of 3400 m to 4200 m area,the remaining 18 cases distributed in 1700 m to 3500 m.57 cases no history of BCG vaccination.CT and magnetic resonance imaging examination showed positive results in 49 cases with ea...