结核性脑膜炎96例临床分析

目的 分析结核性脑膜炎的临床表现、诊断和治疗特点,以提高对该病的诊治水平.方法 对2006年6月至2010年10月我院收治的96例结核性脑膜炎患者的临床资料、实验室检查结果、诊断及预后情况进行总结分析.结果 本组96例结核性脑膜炎多呈慢性或亚急性起病,临床表现以发热、头痛、呕吐为主,脑脊液改变以压力、白细胞、蛋白升高、葡萄糖、氯化物降低为主.87.5％合并颅外结核.头颅CT或MRI检查异常51例,表现为脑积水、结核瘤、脑室扩张、多发病灶等.经正规抗结核治疗,临床治愈52例,好转25例,14例未见好转,自动出院或转院治疗,5例死亡.结论 患者的临床表现、脑脊液、头颅CT或MRI检查、是否合并颅外结核感染及正规抗结核治疗是否有效,是诊断结核性脑膜炎的重要依据；早期诊断及合理治疗可提高结核性脑膜炎的治愈率.

Clinical analysis of 96 cases with tuberculous meningitis

Objective To review the clinical and laboratory features of tuberculous meningitis in order to improve the diagnostic and therapy level for tuberculous meningitis.Methods 96 cases with tuberculous meningitis in our hospital from June 2006 to October 2010 were analyzed.Results The main clinical manifestations of tuberculous meningitis are fever,headache,and vomiting.Abnormality of cerebrospinal fluid includes increased pressure,white blood cell count,and increased protein level,but low leves of glucose and chlorine.Eighty percent(80%) of the cases were cured or improved following conventional anti-tuberculous treatment.Unsuccessful treatment or death was reported in 19(20%) cases.Conclusion The clinical manifestations,cerebrospinal fluid findings,head CT or MRI to find extrapulmonary tuberculosis and diagnostic antituberculous treatment are important for improving the diagnosis of tuberculous meningitis.Eary diagnosis and treatment can improve the cure rate.