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目的探讨肥厚性硬脑膜炎(HCP)的临床特点。方法回顾性分析新疆医科大学第一附属医院神经内科2003年10月~2009年8月收治的经综合治疗的5例HCP患者的临床资料。4例采用类固醇激素(地塞米松)治疗,3例联用青霉素或头孢类抗菌素治疗,2例联用尿激酶溶栓治疗,5例均采用神经营养剂治疗,共2周~1个月。结果 5例患者病情均明显好转,头痛消失或明显减轻,脑神经麻痹完全消失或明显改善。1例9个月后复查MRI,提示硬脑膜未见明显强化。结论根据临床表现和辅助检查结果可尽早明确HCP诊断。应及时予皮质类固醇激素、抗菌素治疗,防止出现不可逆的神经功能缺损。
Objective To investigate the clinical features of hypertrophic dura meningitis (HCP). Methods The clinical data of 5 patients with HCP treated by comprehensive treatment in Department of Neurology, the First Affiliated Hospital of Xinjiang Medical University from October 2003 to August 2009 were retrospectively analyzed. 4 cases were treated with steroid hormone (dexamethasone), 3 cases were treated with penicillin or cephalosporin antibiotics, 2 cases were treated with urokinase thrombolysis, and 5 cases were treated with neurotrophic agent for 2 weeks to 1 month. Results All the 5 patients were significantly improved in condition, headache disappeared or significantly reduced, paralysis of the brain completely disappeared or significantly improved. One case of 9 months after the review of MRI, suggesting no significant dura mater enhancement. Conclusion According to the clinical manifestations and laboratory examinations, HCP diagnosis can be confirmed as soon as possible. Should be timely corticosteroids, antibiotics, to prevent irreversible neurological deficits.