136例成人结核性脑膜炎治疗的回顾性分析  

Retrospectively analyzing the treatment of tubercular meningitis in 136 adult cases

作　　者：邢国胜 马瑞雪 马忠慧[2] 赵轶敏 孔瑞华 

机构地区：[1]河南医学高等专科学校,河南郑州451191 [2]河南省胸科医院,河南郑州450003

出　　处：《中国卫生检验杂志》2017年第8期1153-1154,1160,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨成人结核性脑膜炎的临床特征及治疗手段,总结诊疗方法。方法选取本院2005年-2010年收治的136例成人结核性脑膜炎的临床资料进行回顾性分析,并根据患者的病情,给予以异烟肼(INH)、利福平(RFP)为主的五联化疗,辅以大剂量激素,放脑脊液以降低颅内压等治疗手段。结果治愈55例(40.4%),好转66例(48.5%),死亡10例(7.4%),后遗症5例(3.7%)。脑脊液恢复正常时间为26 d^360 d,平均为120 d。尚有个别患者住院不足3个月,好转出院。随访1年,存活108例(79.4%)。结论早期高颅压的积极有效防治、激素的恰当适量应用、抗结核药物的正确选择是治疗结核性脑膜炎的关键。Objective To explore the clinical features and treatment methods of adult tubercular meningitis （TM） in order to summarize the methods of diagnosis and treatment. Methods The clinical data of 136 patients with TM who had been treated in our hospital from 2005 to 2010 were analyzed retrospectively. According to the severity of desease, they were treated by five therapy including isoniazide（INH） and rifampin（ RMP）, supplemented by high dose steroid and remove cerebral - spinal fluid to reduce intracranial pressure. Results After treatment, cure occurred in 55 cases, occupying 40.4% of the total, effective- ness in 66 cases（48.5% ）, death in 10 cases（7.4% ）, and sequelae in 5 cases（3.7% ）. CSF need 26 d -360 d to become normal, with an average of 120d. and there was few patients leaving hospital in less than 3 months. The patients were followed up for 1 year, with 108 cases survived. Conclusion It is the key for the treatment of tuberculous meningitis to control intracra- nial oressure in early st^e. use steroid reasonably and select anti -TB drugs correctlv.

关 键 词：结核性脑膜炎 化疗 综合治疗 

分 类 号：R529.3[医药卫生—内科学]