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[目的]探讨小儿不典型结核性脑膜炎的诊断,减少误诊、误治。[方法]回顾性分析36例不典型结核性脑膜炎患儿的临床资料。[结果]36例中初步诊断误诊为化脓性脑膜炎12例,病毒性脑炎8例,败血症6例,上呼吸道感染4例,电介质紊乱2例,心肌炎2例,颅内出血1例,中毒性脑病1例。[结论]掌握该病早期不典型及多样化表现,详细询问病史及仔细体检,综合分析辅助检查,是减少对该病误诊的关键。
[Objective] To investigate the diagnosis of atypical tuberculous meningitis in children and reduce the misdiagnosis and mistreatment. [Methods] The clinical data of 36 children with atypical tuberculous meningitis were retrospectively analyzed. [Results] The initial diagnosis of misdiagnosis in 36 cases was purulent meningitis in 12 cases, viral encephalitis in 8 cases, sepsis in 6 cases, upper respiratory tract infection in 4 cases, dielectric disturbance in 2 cases, myocarditis in 2 cases, intracranial hemorrhage in 1 case, toxic Encephalopathy in 1 case. [Conclusion] To grasp the atypical and diversified manifestations of early stage of the disease, detailed medical history and careful physical examination, comprehensive analysis of the auxiliary examination is the key to reduce the misdiagnosis of the disease.