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本文总结1978～1983年住院小儿结核398例中死亡44例,16例作了尸解,结合临床和尸检进行综合分析,以期找出治疗失败原因。44例中35例(8.7%)死于治疗过程中,9例死于出院后。中期8例,晚期36例。通过分析,经治疗后小儿结脑死因,住院后短期内死亡者,多由于高热惊厥和/或合并肺炎,类 Herxheimer 反应所致的脑水肿和出血。治疗已久死因有持续性颅压高,严重代碱,以上症状的病理基础是脑室炎,脑膜脑炎所致的脑室扩张、颅底粘连,脑干结核等,使药物不易进入病变部位,细菌耐药也是治疗失败原因,久病致细胞免疫功能低下,胸腺发育不良也应注意。
This article summarizes the 1978 ~ 1983 hospitalized 398 cases of pediatric tuberculosis death in 44 cases, 16 cases were autopsied, combined with clinical and autopsy analysis, in order to find the cause of treatment failure. Of the 44 patients, 35 (8.7%) died during the treatment and 9 died after discharge. 8 cases in the middle and 36 cases in the late stage. Through analysis, after treatment of children with tuberculous brain death, short-term death after hospitalization, and more due to febrile seizures and / or pneumonia, hernia-induced brain edema and bleeding. The treatment has long been the cause of death due to persistent high intracranial pressure, a serious generation of alkali, the pathological basis of the above symptoms is ventricular inflammation, meningoencephalic ventricular dilatation, skull base adhesions, brainstem tuberculosis, the drug is not easy to enter the lesion, bacteria Resistance is also the cause of treatment failure, chronic illness caused by cellular immunity, thymus dysplasia should also be noted.