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目的:探讨结核性脑膜炎的临床特点和诊治方案。方法:回顾性分析92例结核性脑膜炎临床病例,确诊后均主要予以异烟肼、利福平、乙胺丁醇、比嗪酰胺(HRZE)联合、足量抗痨,另外根据患者本身的肝肾功能,是否合并乙肝活动等个体情况,再适当调整方案,在抗痨期间同时加用激素及对症支持治疗,观察其治疗效果。结果:67例以全身抗痨为主的患者,好转率67%,25例以全身抗痨加脑脊液置患者,治愈和好转率96%。结论:提高对结核性脑膜炎临床特点的认识,才能早期诊断,早期治疗,降低病死率及致残率;脑脊液鞘内注药加脑脊液置换可有效提高脑脊液中药物浓度,降低颅内压,防止脑疝,提高治愈率,减少后遗症。
Objective: To investigate the clinical features and diagnosis and treatment of tuberculous meningitis. Methods: A retrospective analysis of 92 cases of tuberculous meningitis clinical cases were diagnosed with isoniazid, rifampicin, ethambutol, azinamide (HRZE) combined with adequate anti-gall bladder, in addition to the patient’s own Liver and kidney function, whether combined with hepatitis B activity and other individual circumstances, and then adjust the program, during the anti-tuberculosis also add hormones and symptomatic supportive treatment to observe the therapeutic effect. Results: 67 cases of systemic anti-tuberculosis-based patients, the improvement rate of 67%, 25 cases of systemic anti-tuberculosis and cerebrospinal fluid placement, cure and improvement rate of 96%. Conclusion: To improve the understanding of the clinical features of tuberculous meningitis in order to early diagnosis and early treatment, reduce mortality and disability rate; intrathecal injection of cerebrospinal fluid and cerebrospinal fluid replacement can effectively increase the concentration of drugs in cerebrospinal fluid, reduce intracranial pressure and prevent Hernia, improve the cure rate, reduce sequelae.