彝族地区小儿结核性脑膜炎临床特征分析

The clinical characteristics analysis of tuberculous meningitis of children in Yi Nationality region

目的分析彝族地区小儿结核性脑膜炎的临床特征,探讨早期诊断的有效方法,减少误诊。方法回顾性分析2010年1月-2012年12月我院71例临床诊断结核性脑膜炎的住院患儿病例资料。结果农村彝族患病率高,占全组病例90.1%,全组病例仅4例有明确卡介苖接种史。全组患儿主要临床表现为:发热,神经系统症状颅内压增高和脑膜刺激征。胸部X线片或胸部CT异常31例(47.0%),其中粟粒型结核6例(19.4%)。全组69例行头部CT,42例异常,阳性率为60.9%,其中33例伴随脑积水改变(46.5%)。结论发热伴颅内压增高,脑神经损害是小儿结核性脑膜炎常见的表现。彝族地区卡介疫苖接种覆盖率低,发病率高,应重视宣传及加强对基层的防疫工作。头颅CT是结核性脑膜炎早期诊断和判断预后比较有效的方法。对疑诊患者或脑脊液不典型患者应早期行头部CT及胸部X线片检查。

Objective To analysis the clinical characteristics of tuberculous meningitis of children in Yi Nationality region. Methods Retrospective analysis the clinical characteristics analysis of tuberculous meningitis of children in Yi Nation- ality region from January,2010 to February,2012. Results Tuberculous meningitis from countryside occupied 90.1%. g cases of tuberculous meningitis have clear history of BCG vaccination. The main clinical manifestations were fever, neurological symp- toms,increased intracranial pressure, meningeal irritation. 31 cases （47.0%）with cest X-ray, CT abnormalities. Among of them,6 cases patients with miliary tuberculosis（ 19.4% ）. 69 cases patients examined by CT,42 cases patients were abnormal （60.9%） ,33 cases patients with hydrocephalus（46.5% ）. Conclusion The famous clinical manifestation were increased in- tracranial pressure brain damage. The coverage rate of Yi Nationality was lower. Should strength the propaganda. Cranial CT is the best diagnosis and treatment ways. Patients suspected should examined by CT scan and X-ray.