小儿结核性脑膜炎58例临床分析

The clinical analysis of tuberculosis meningitis in fifty-eight children

目的 分析小儿结核性脑膜炎的临床特点,为早期诊断、治疗提供依据.方法 对我院2010～2012年收治的58例小儿结核性脑膜炎的临床资料进行回顾性分析.结果结核性脑膜炎在藏族及农村儿童发病率高,发病季节以春、夏多见.以发热、颅内压增高为主要临床表现,81.03%患儿合并有肺结核,痰及脑脊液查抗酸杆菌阳性率低,头颅MRI是结核性脑膜炎早期诊断和判断预后有效方法.早期诊断、规律化疗是决定预后的关键因素.结论加强对农村贫困藏族人口进行结核病防治科普知识的宣传,做到早就诊.对临床资料进行综合分析,做到早诊断.规律抗痨配合综合治疗能提高疗效.

Objective To analyze the clinical characteristics of tuberculosis meningitis （TBM）in children. Provides the basis for early diagnosis and treatment. Methods Retrospective analysis of child TBM clinical data which the onset of age,ethnic, clinical symptoms,signs,laboratory tests,treatment and prognosis 2010 ~ 2012 admitted my courtyard. Results TBM in children in Tibetan and rural areas with a high incidence of a disease. Onset of the season in spring, summer common. The main manifesta- tions of the 58 patients with TBM were：fever,intracranial hypertension;81.03% of children associated with pulmonary tuberculo- sis;Acid-fast bacilli sputum and cerebrospinal fluid to check low rate of positive;Tuberculous meningitis, cranial MRI was effective method for early diagnosis and prognosis. Early diagnosis, regular chemotherapy was the key factor that determines the prognosis. Conclusion Strengthen the propaganda of popular science knowledge of TB prevention and control on rural poverty in Tibetan population. So that early to see a doctor could achieve early diagnosis. Regular anti-tuberculosis combined comprehensive treatment could improve curative effect.