论文部分内容阅读
明斯克地区结核病防治所对以结核性脑膜炎诊断收进专科病房的40例患者进行了研究。患者年龄为14～68岁。其中13例误诊为本病。入院后经进一步检查,确诊为:浆液性脑膜炎7例、化脓性脑膜炎1例、脑脓肿3例、脑肿瘤和脑溢血各1例。误诊为本病者以浆液性脑膜炎居多。误诊与对临床症状、并发症、脑脊液改变和病程的不正确评价有关。7例的误诊原因是对活动性结核的肺部改变的误解。上述13例非结核性脑膜炎患者,在初期具有本病的典型症状:起病急和迅速发生脑膜综合征及脑脊液的特征性改变,造成误诊的倾向。而且,对患者以后出现的变化没有加以正确的评价。如脑脊液蛋白含量增高(本病的特点)仅2例(1.12～1.65‰),而其余11例却不超过1‰。没有考虑大多数患者(11例)脑脊液的糖含量在正常范围(只2例轻度下降至38～35mg%)。本病脑脊液
The Minsk Region’s Tuberculosis Prevention and Treatment Unit conducted a study of 40 patients admitted to specialist wards for the diagnosis of tuberculous meningitis. Patients aged 14 to 68 years old. 13 cases were misdiagnosed as the disease. After admission, further examination confirmed as serous meningitis in 7 cases, purulent meningitis in 1 case, brain abscess in 3 cases, brain tumor and stroke in 1 case. Misdiagnosed as the majority of patients with serous meningitis. Misdiagnosis is associated with incorrect evaluation of clinical symptoms, complications, cerebrospinal fluid changes, and course of disease. The misdiagnosis of 7 patients was a misinterpretation of lung changes in active TB. The 13 cases of non-tuberculous meningitis in patients with early symptoms of the disease typical: rapid onset and rapid occurrence of meningeal syndrome and cerebrospinal fluid changes in the characteristics, resulting in a tendency to misdiagnosis. Moreover, the patient’s future changes have not been properly evaluated. Such as cerebrospinal fluid protein content (the characteristics of the disease) only 2 cases (1.12 ~ 1.65 ‰), while the remaining 11 cases did not exceed 1 ‰. The majority of patients (11 patients) did not consider the cerebrospinal fluid in the normal range (only 2 patients slightly reduced to 38-35 mg%). The disease cerebrospinal fluid