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目的对49例结核病脑膜炎进行临床分析。方法抗结核四联及激素和对症等支持治疗。脑脊液糖和氧化物同时降低者占93.8%,成为实验室诊断结脑的有力证据。结脑合并肺结核占20%,脑CT阳性率占66.1%,对结脑只有诊断价值。结果好转出院占57%,自动离院和死亡占42.8%。结论结脑由于治疗过晚或不规则治疗可出现各种并发症,最常见的脑积水、脑梗塞及脑萎缩,常成为结脑的死亡原因。影响预后的因素主要取决于治疗早晚,治疗越晚,病死率越高;年龄越小,结脑发展越快越严重;合并脑积水者死亡率高;治疗方法不妥当、药物剂量不足,预后本应较好的早期、中期结脑患儿可变为迁延或慢性。
Objective To analyze the clinical data of 49 cases of tuberculosis meningitis. Methods of anti-TB quadruple hormone and symptomatic and other supportive treatment. Cerebrospinal fluid sugar and oxide simultaneously accounted for 93.8%, has become a strong evidence of laboratory diagnosis of tuberculosis. Tuberculosis brain tuberculosis accounted for 20%, brain CT positive rate accounted for 66.1%, only the diagnosis of tuberculous meningitis. Outcomes improved 57% of discharged, automatic leaving and death accounted for 42.8%. Conclusion Tuberculous meningitis due to treatment of late or irregular treatment can occur a variety of complications, the most common hydrocephalus, cerebral infarction and brain atrophy, often become the brain death causes. The prognostic factors mainly depend on the treatment sooner or later, the later the treatment, the higher the case fatality rate; the younger, the more severe the development of tuberculosis; the high mortality rate with hydrocephalus; inappropriate treatment, inadequate drug dose, prognosis This should be better in the early, mid-term tuberculous child may become persistent or chronic.