吻膝试验和坐位低头试验对发现早期脑膜刺激征的临床研究

CLINICAL STUDY OF KISS-KNEE AND BOW SEAT TESTS ON EARLY DETECTION OF MENINGEAL IRRITATION

目的探讨吻膝试验与坐位低头试验早期发现脑膜刺激征的临床价值。方法选自1980-2004年累积的疑诊脑膜炎病例225例,试用吻膝试验和坐位低头试验,并同步作腰穿取脑脊液验证。结果 7岁以下者阳性率略低于8岁以上者,8岁以上者阳性率达100%;第1病日就诊者阳性率高达90.4%,第2病日阳性率达94.6%,第3病日阳性率达100%;225例中,随机同步腰穿、吻膝试验和坐位低头试验阳性者194例占86.2%;脑脊液检查异常167例占86.1%;脑脊液沉淀作涂片及培养找到相应疾病致病菌89例占45.9%。取脑脊液验证的病例中,无发现有假阳性者。结论吻膝试验和坐位低头试验,可作为腰穿取脑脊液检验的指征。为早期发现、早期诊断、早期治疗,提供简单的物理辅助检查脑膜刺激征的方法。

Objective To explore the early detection of meningeal irritation. Methods Two hundred and twenty-five patients suspected meningitis from 1980 to 2004 were received the kiss-knee test and bow seat test. Results The positive rate of the group older than 8 years of age was 100% and that of the group younger than 7 years of age was slightly less in both tests; the positive rates in the visiting patients was as high as 90.4% in the first day of sickness,94.6% in the second day, and 100% in the third day, respectively. The positive rate of lumbar puncture was 86.2% （ 194/225 cases） in the patients who simultaneously received the kiss-knee test and bow seat test ;Cerebrospinal fluid showed abnormal in 167 cases （86.1% ） ; Pathogens were found in 89 cases （45.9%） by cerebrospinal fluid smear and culture; No false positive cases were found in cerebrospinal fluid examination verified cases. Conclusion Kiss-knee test and bow seat test can be used to give evidence for perform the lumbar puncture and cerebrospinal fluid tests,which are helpful to the early detection, early diagnosis, and early treatment for the meningeal irritation in the patients with meningitis.