综合性医院成人结核性脑膜炎早期诊断价值及措施

目的 :探讨结核性脑膜炎早期诊断依据和确诊时间对治疗效果的影响。方法 :对 1993～ 1998年间住院后确诊为结核性脑膜炎的 42例患者进行回顾性分析。结果 :结核性脑膜炎以春秋季好发 ,女性多于男性。年龄多在40岁以下 (占 73 .81% )。以急性起病多见 (71.43% ) ,首发症状以头痛、发热为多数 (占 73.81% ) ,其中有夜间头痛者占 95 .2 4% ,所有患者脑膜刺激征均为阳性。脑脊液中蛋白升高与氯化物降低具有同等重要的意义。外周血白细胞总数与脑脊液中白细胞数量呈低度负相关。确诊时间越早 ,疗效越好。结论 :结核性脑膜炎的早期诊断需综合考虑发病年龄、起病形式、首发症状、体征及辅助检查。早期诊断有利于治疗

The Handles and Significance of Early Comfirmed Diaguosis of Adult Tubercular Meningitis

Objectives To probe into the effect of the basis and the time of diagnosis on treatment of the adult tubercular meningitis. Methods 42 cases with tubercular meningitis were precisely diagnosied during 1993 and 1998 and engaged in retrospective analysis.Results The stage of onset of adult tubercular meningitis was mostly in spring and autumn. The female patients were in the majority. The age of most patients were below 40 years(made up 73.81% of the total patients). Sudden onset accounted for 71.43% of the total cases. The initial syndrome of most patients were headaches and fever (amount to 73.81% of the total patients), and 95.24% of them were nocturnal headaches. All of the patients meningeal irritation sign were positive. The meaning was same as the elevation of protein and the lowering of chloride in cerebrospinal fluid. The total number of the white blood cells in the peripheral blood and cerebrospinal fluid presented lowly negative correlation. Earlier the diagnosis, the more curative the effect.Conclusions Early diagnosis of adult tubercular meningitis has to take into account all factors such as age and mode of onset, initial syndrome,physical sign and accessory examination.Early diagnosis is advantageous to treatment.