發(fā)布時間：2018-06-12 07:28

  本文選題：中樞神經(jīng)系統(tǒng)感染 + 病毒性腦炎　； 參考：《河北醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：中樞神經(jīng)系統(tǒng)感染是指腦實質(zhì)和脊髓及其被膜和血管等受到病源微生物（包括細(xì)菌、真菌、病毒、螺旋體、寄生蟲、立克次體和朊蛋白等）的侵襲而發(fā)生的急性或慢性炎癥性疾病，是神經(jīng)系統(tǒng)的常見疾病之一。我國每年中樞神經(jīng)系統(tǒng)感染的發(fā)病人數(shù)超過百萬例，其患者病死率高，并可造成嚴(yán)重的神經(jīng)系統(tǒng)后遺癥，是嚴(yán)重威脅人類健康的感染性疾病。病毒性腦膜炎或腦炎(簡稱病腦)、化膿性腦膜炎(簡稱化腦)、結(jié)核性腦膜炎(簡稱結(jié)腦)、隱球菌性腦膜炎(簡稱隱腦)以及腦囊蟲病是臨床上常見的類型�；谶@一現(xiàn)狀，關(guān)于中樞神經(jīng)系統(tǒng)感染的流行分布情況的研究日益增多，但多集中于對某一種病原體進(jìn)行研究，缺乏全面的流行病學(xué)分布特點總結(jié)。而石家莊地區(qū)中樞神經(jīng)系統(tǒng)感染方面的文獻(xiàn)資料則更為缺乏。 本文通過分析9067例患者的臨床資料，旨在了解石家莊地區(qū)常見中樞神經(jīng)系統(tǒng)感染性疾病的演變情況、分布情況和病原譜特點，進(jìn)而總結(jié)中樞神經(jīng)系統(tǒng)感染性疾病的發(fā)病特點、發(fā)展趨勢及分布規(guī)律，從而豐富國家感染性疾病資料庫，為中樞神經(jīng)系統(tǒng)感染性疾病的研究指引方向，為防病工作提供指導(dǎo)。 方法：對河北醫(yī)科大學(xué)第二醫(yī)院1996—2011年16間收治的常見中樞神經(jīng)系統(tǒng)感染患者的臨床資料進(jìn)行整理。將符合條件的病例按病原種類分為病腦組、結(jié)腦組、化腦組、隱腦組、腦囊蟲組五組。收集包括入院日期，出院日期，患者姓名，性別，年齡，主要診斷，主要診斷轉(zhuǎn)歸，其他診斷，其他診斷轉(zhuǎn)歸，患者職業(yè)，家庭住址等信息，并從病種分布，年度分布，季節(jié)分布，住院天數(shù)、年齡分布、性別構(gòu)成、城鄉(xiāng)分布、職業(yè)分布等方面匯總各組信息，并進(jìn)行綜合分析。 結(jié)果：16年間我院共收治常見中樞神經(jīng)系統(tǒng)感染性疾病的患者9067例，這其中病毒性腦（膜）炎6719例（74.10%），化膿性腦膜炎580例（6.40%），結(jié)核性腦膜炎816例（9.00%），隱球菌性腦膜炎83例（0.92%），腦囊蟲病869例（9.58%）。2004—2011年，病毒性腦（膜）炎、化膿性腦膜炎、結(jié)核性腦膜炎、隱球菌性腦膜炎的病例數(shù)較前8年分別增加了219.68%、63.64%、46.53%、318.75%。腦囊蟲病例數(shù)較前8年下降了52.96%。病毒性腦炎或腦膜炎主要集中在7—9月份，結(jié)核性腦膜炎集中于4—6月份。病毒性腦（膜）炎、化膿性腦膜炎均多見于10歲以下兒童，結(jié)核性腦膜炎多見于20—29歲的青年，而腦囊蟲病則更多出現(xiàn)在10—19歲的青少年�；撔阅X膜炎與腦囊蟲病男女性別差異明顯分別為1.90:1、1.66:1。中樞神經(jīng)系統(tǒng)感染性疾病主要分布在鄉(xiāng)村，其中化膿性腦膜炎的城鄉(xiāng)差別最為明顯，農(nóng)村病例占87.93%。病毒性腦（膜）炎患者職業(yè)以學(xué)生為主（33.06%），化膿性腦膜炎患者以兒童多見（58.84%），結(jié)核性腦膜炎、隱球菌性腦膜炎、腦囊蟲病均多見于農(nóng)民（分別為49.38%、50.91%、62.03%）。 結(jié)論：近年來，中樞神經(jīng)系統(tǒng)感染性疾病在河北省石家莊市及其周邊地區(qū)有明顯的增加趨勢，提示臨床工作者應(yīng)對中樞神經(jīng)系統(tǒng)感染性疾病的發(fā)病機制、診斷及治療措施進(jìn)行深入研究，提請有關(guān)部門加大重視力度，制定更加科學(xué)的防治策略，為防治工作提供指導(dǎo)。
[Abstract]:Objective: central nervous system infection is an acute or chronic inflammatory disease occurring in the brain parenchyma and spinal cord, its membrane and blood vessels, such as bacteria, fungi, viruses, heliospin, parasites, Rickettsia and prion protein, and so on. It is one of the common diseases of the nervous system. More than a million cases of infection are infected, with high mortality and severe neurological sequelae. It is an infectious disease that is a serious threat to human health. Viral meningitis or encephalitis (abbreviated brain), pyogenic meningitis (abbreviated as brain), tuberculous meningitis (abbreviated brain), cryptococcal meningitis (referred to as hidden brain). Brain cysticercosis is a common clinical type. Based on this situation, the prevalence of central nervous system infection is growing more and more, but most of them are focused on the study of a certain pathogen and lack of a comprehensive epidemiological distribution. The literature of the central nervous system infection in Shijiazhuang is more important. Lack.
By analyzing the clinical data of 9067 patients, this paper aims to understand the evolution, distribution and characteristics of the common central nervous system infectious diseases in Shijiazhuang, and then summarize the characteristics, trends and distribution rules of the infectious diseases of the central nervous system, so as to enrich the national database of infectious diseases. Guidelines for research on infectious diseases of the central nervous system provide guidance for disease prevention.
Methods: the clinical data of the common central nervous system infection in 16 Hospital of Hebei Medical University from 1996 to 2011 were arranged. The cases were divided into five groups according to the pathogenic species, including the brain group, the brain group, the brain group, the hidden brain group and the cerebral cysticercosis group. The date of admission, the date of discharge, the name of the patient, the sex, and the year were collected. Age, the main diagnosis, main diagnosis, other diagnosis, other diagnosis, other diagnosis, career, home address and other information, and from the disease distribution, annual distribution, seasonal distribution, the number of days in hospital, age distribution, gender composition, urban and rural distribution, occupational distribution and other aspects of the summary of the information, and comprehensive analysis.
Results: in 16 years, 9067 cases of common central nervous system infection were treated in our hospital, including 6719 cases (74.10%) of viral brain (membranous) inflammation, 580 cases of suppurative meningitis (6.40%), 816 cases of tuberculous meningitis (9%), 83 cases of cryptococcal meningitis (0.92%), 869 (9.58%) cysticercosis (9.58%),.2004 - 2011, viral brain (membranous), suppurative The number of cases of meningitis, tuberculous meningitis and cryptococcal meningitis increased by 219.68%, 63.64%, 46.53%, respectively, and the number of 318.75%. cerebral cysticercosis decreased more than the previous 8 years. 52.96%. viral encephalitis or meningitis was mainly concentrated in 7 - September. Tuberculous meningitis was concentrated from 4 to June. Viral brain (membrane) inflammation and suppurative meningitis were all More common in children under 10 years of age, tuberculous meningitis often seen in young people aged 20 to 29, while cysticercosis occurs more in adolescents aged 10 to 19. The gender differences between the sexes of purulent meningitis and cysticercosis are obviously 1.90:1,1.66:1. central nervous system infectious diseases mainly distributed in the countryside, including the urban and rural purulent meningitis. The difference was most obvious. The occupations of 87.93%. viral brain (membranous) patients in rural cases were mainly students (33.06%). The cases of suppurative meningitis were mostly seen in children (58.84%), tuberculous meningitis, cryptococcal meningitis and cysticercosis (49.38%, 50.91%, 62.03% respectively).
Conclusion: in recent years, the infectious diseases of central nervous system have obviously increased in Shijiazhuang and its surrounding areas in Hebei province. It suggests that the clinical workers should study the pathogenesis, diagnosis and treatment measures of the central nervous system infectious diseases, and ask the relevant departments to pay more attention to the prevention and treatment of the diseases. Strategy to provide guidance for the prevention and control work.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R725.1

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