52例成人初治重症结核性脑膜炎诊治体会

The Experience of Diagnosis and Treatment of 52 Cases With Adult Intensive Tuberculous Meningitis

目的:总结成人重症结核性脑膜炎的临床特点,并探讨治疗方法。方法:回顾我院近4年收治的52例成人初治重症结核性脑膜炎状况进行临床分析。结果:52例结脑患者经规范化及个体化抗结核治疗,27例患者好转(51.9%),11例患者病情加重(21.2%),9例病情无明显改善(17.3%),5例死亡(9.6%)。结论:重症结核性脑膜炎患者病情重、进展快,尤其是中老年患者,治疗效果相对较差,病死率相对较高。预后与治疗的早晚密切相关,经予规范化及个体化治疗可一定程度改善预后。

Objective： To summarize clinical characteristics of adult tuberculous meningitis and investigate the treatment method. Methods： 52 cases of adult intensive tuberculous meningitis were reviewed and analyzed in our hospital in resent 4 years. Results：With Standard and Individualized anti - tuberculosis treatment, 27patients were improved（51.9 % ） , l lcases exacerbated（21.2 % ）, The condition of 9 cases did not change significandy （17.3 % ）, 5 cases died（9.6 % ）. Conclusion： The adult intensive tuberculous meningitis are serious disease, rapid deterioration and high mortality, In particular, the treatment effect relatively poor in elderly patients, the mor- tality relatively higher. The prognosis is closely related with the treatment sooner or later, Standard and Individ- ualized anti- tuberculosis treatment can Improve prognosis to a certain extent.