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本文总结了４４例结核性脑膜炎（结脑）的诊治经验。提出本病早期误诊，多因缺乏对本病的警惕性。人型ＰＰＤ试验阴性率高达４７．７％，故阴性者亦不能完全排除，滥用氨基糖甙类抗菌素及糖皮质激素，使病情隐蔽增加误诊机会。脑脊液的结核菌ＰＣＲ检查及反复多次进行胸部Ｘ线检查有利于确立诊断，头颅ＣＴ或ＭＲ检查有助于发现脑积水。对结脑的治疗除了控制结核感染外，还要注意防治并发症，对脑梗阻患者行侧脑室持续冲洗置换术治疗可收到良效。
This article summarizes the diagnosis and treatment of 44 cases of tuberculous meningitis (tuberculosis) experience. Proposed early misdiagnosis of this disease, mostly due to lack of vigilance of the disease. Human-type PPD test negative rate as high as 47.7%, so the negative can not be completely ruled out, abuse of aminoglycoside antibiotics and glucocorticoids, the disease hidden to increase misdiagnosis opportunities. Mycobacterium tuberculosis PCR of cerebrospinal fluid and repeated chest X-ray examination is conducive to the establishment of diagnosis, head CT or MR examination can help find hydrocephalus. Treatment of tuberculous meningitis in addition to controlling tuberculosis infection, but also pay attention to prevention and treatment of complications, cerebral infarction in patients with lateral ventricular continuous irrigation replacement therapy can receive good results.