本文關(guān)鍵詞： 結(jié)核性腦膜炎 臨床表現(xiàn) 輔助檢查 不良反應(yīng) 維生素C　出處：《重慶醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討結(jié)核性腦膜炎臨床表現(xiàn)、腦脊液改變、影像學(xué)特點(diǎn)、診治方法、抗結(jié)核藥物不良反應(yīng)及其轉(zhuǎn)歸。 方法：2009年-2012年重醫(yī)附一院收治結(jié)核性腦膜炎患者200例，，對(duì)其病例資料進(jìn)行回顧性分析。 結(jié)果：本組200例病例中,以頭痛、發(fā)熱、惡心、嘔吐為主要臨床表現(xiàn)，病程中出現(xiàn)精神行為異常、大小便障礙、顱神經(jīng)麻痹、抽搐等癥狀；腦脊液檢查中壓力增高者占58%，有核細(xì)胞數(shù)20-500*106/l居多(75.5%)，糖明顯降低（＜50%）占90.5%。MRI陽性率（65.5%）遠(yuǎn)大于CT陽性率(29%)，發(fā)現(xiàn)并發(fā)腦梗死者為24.5%；經(jīng)治療后172例（86%）病情好轉(zhuǎn)出院，抗結(jié)核藥物不良反應(yīng)中肝損害發(fā)生比率最高，且預(yù)防使用糖水+維生素C對(duì)抗結(jié)核藥物引起肝損害無效。 結(jié)論：臨床醫(yī)生應(yīng)從不典型臨床表現(xiàn)以及輔助檢查等對(duì)結(jié)核性腦膜炎作出早診斷、早治療，充分認(rèn)識(shí)結(jié)核性腦膜炎合并腦梗死，加大早期治療力度，減少并發(fā)癥及后遺癥的發(fā)生，降低致殘率及死亡率，提高治愈率,盡可能降低抗結(jié)核藥物引起不良反應(yīng)。
[Abstract]:Objective: to investigate the clinical manifestations, cerebrospinal fluid changes, imaging features, diagnosis and treatment of tuberculous meningitis, antituberculous drug adverse reactions and their outcome. Methods: from 2009 to 2012, 200 cases of tuberculous meningitis were retrospectively analyzed. Results: the main clinical manifestations of 200 cases were headache, fever, nausea and vomiting. In cerebrospinal fluid examination, the pressure increased in 58 patients, the number of nuclear cells 20-500 ~ 106 / l was 75.55.55, the sugar decreased significantly (< 50) and the MRI positive rate was much higher than the CT positive rate of 29.5. It was found that the patients complicated with cerebral infarction were 24.55.The patients with cerebral infarction got better after treatment and were discharged from hospital. The incidence of liver damage was the highest in the adverse reactions of antituberculotic drugs, and the prevention of liver damage caused by antituberculous drugs with sucrose vitamin C was ineffective. Conclusion: clinicians should make early diagnosis and treatment of tuberculous meningitis from atypical clinical manifestations and auxiliary examinations, fully understand tuberculous meningitis with cerebral infarction, and increase the intensity of early treatment. To reduce the incidence of complications and sequelae, to reduce the rate of disability and mortality, to improve the cure rate, and to reduce the adverse reactions caused by anti-tuberculosis drugs as far as possible.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R529.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 林濤;王學(xué)峰;曾艷;李勁梅;席志芹;肖飛;;難治性癲癇患者顳葉新皮質(zhì)中NCAM-140kDa的表達(dá):顳葉新皮質(zhì)的可塑性與難治性癲癇的關(guān)系[J];中風(fēng)與神經(jīng)疾病雜志;2008年03期

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