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find Keyword "结核性脑膜炎" 14 results
  • Could Corticosteroids Be Used for Pulmonary Tuberculosis Combined with Tuberculous Meningitis and Tuberculous Pericarditis: An Evidence-based Treatment for a 14-year-old Boy

    Objective To formulate an evidence-based treatment for a patient with pulmonary tuberculosis combined with tuberculous meningitis and tuberculous pericarditis. Methods According to the principles of evidencebased clinical practice, we searched The Cochrane Library (Issue 2, 2008), Ovid-Reviews (1991 to 2008), MEDLINE (1950 to 2008), and http://www.guideline.org. to identify the best evidence for treating a patient with pulmonary tuberculosis combined with tuberculous meningitis and tuberculous pericarditis. Results Nine guidelines, 2 systematic reviews, and 11 randomized controlled trials were included. The evidence showed that corticosteroids could help reduce the risk of death and disabling residual neurological deficiencies in patients with tuberculous meningitis. After adjusting for age and gender, the overall death rate of patients with tuberculous pericarditis was significantly reduced by prednisolone (P=0.044), as well as the risk of death from pericarditis (P=0.004). But for patients with pulmonary tuberculosis, there was still a controversy about the use of corticosteroids. Given the evidence, the patient’s clinical conditions, and his preferences, dexamethasone was used for the boy in question. After 7 weeks of treatment, his cerebrospinal fluid returned to normal and pericardial effusion disappeared. Conclusion  Corticosteroids should be recommended in HIV-negative people with tuberculous meningitis or/and tuberculous pericarditis. The difference in the effectiveness of various corticosteroids such as dexamethasone, prednisolone, or methylprednisolone and the optimal duration of corticosteroid therapy is still unknown.

    Release date:2016-08-25 03:36 Export PDF Favorites Scan
  • Clinical Analysis of 126 Patients with Tuberculous Meningoencephalitis

    Objective To investigate the clinical features of tuberculous meningoencephalitis.Methods The clinical characteristics and laboratory results of 126 cases who were diagnosed as tuberculous meningoencephalitis fromJanuary 2000 to April 2009 were analyzed retrospectively. Results The clinical manifestations of tuberculous meningoencephalitis included fever, headache, vomitting, hemiparalysis,paraplegia, mental anomaly, hypopsia, deafness, diplopia, muscular spasms, coma, and incomplete oculomotor palsy, etc. Vomitting which was characteristic symptom of tuberculous meningoencephalitis was found in 25 cases( 19. 8% ) . The diagnosis was confirmed more than eightweeks after the onset of the disease in 31 cases ( 24. 6% ) . The inhospital mortality rate of tuberculous meningoencephalitis was 14. 3% ( 18 /126) . The inhospital mortality rate of re-treatment patients was 42. 9% ( 6 /14) . In 41 patients with poor prognosis ( death or therapy failure) , 68. 3% ( 28/41) cases were complicated with military tuberculosis, which was higher than the overall occurrence of 41. 3% ( 52/126) . Conclusions Strict diagnostic criteria and atypicalsymptoms lead to delayed diagnosis, delayed treatment, and high mortality in patients with tuberculous meningoencephalitis, particularly in patients with military tuberculosis and re-treatment patients. There is still no effective treatment which have a significant impact on the prognosis.

    Release date:2016-08-30 11:53 Export PDF Favorites Scan
  • Characteristic Analysis and Nursing Measures of Pregnant Women Suffering from Tuberculous Meningitis

    【摘要】 目的 分析总结妊娠合并结核性脑膜炎患者的相关特征及护理经验。 方法 对2010年1-12月收治的8例妊娠合并结核性脑膜炎患者的相关资料进行回顾性分析,并就疾病特点所采取的有效护理措施进行表述。 结果 6例患者好转出院继续治疗(均于出院后1周内终止妊娠),1例经抢救后转院行引产手术,1例因经济原因自动出院。 结论 应大力普及妊娠期结核性脑膜炎相关知识,重视首发症状及腰椎穿刺检查结果,做到早发现,早诊断,早治疗,并采取相应的护理措施,减少并发症和致死率。【Abstract】 Objective To summarize the characteristics of pregnant women with tuberculous meningitis and the nursing measures for these patients. Methods The clinical data of 8 pregnant patients with tuberculous meningitis diagnosed between January 2010 and December 2010 were retrospectively analyzed. The characteristics of race, admitting diagnosis, basis diseases, premiers symptoms, and course of disease were analyzed, and the nursing measures were summarized. Results Six patients recovered and left the hospital (all had terminationed pregnancy after discharge within one week), one was transferred to another hospital for induction of labor after emergency rescue, one left the hospital for economical reason. Conclusions The propagation of the knowledge of tuberculous meningitis is very important. We should pay more attention to its early symptoms, corning′s puncture examination and give suitable nursing care as soon as possible.

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • Clinical Study of 68 Tuberculous Meningitis Patients

    目的:分析结核性脑膜炎的临床及治疗中影响预后的因素。方法:回顾分析10 年来我院收治的68 例结核性脑膜炎患者的临床及实验室资料。结果:59 例患者痊愈,5 例患者遗留肢体后遗症,4 例患者死亡。结论:治疗结核性脑膜炎过程中积极区分引起低钠血症的原因及鉴别药物热与类赫氏反应并给以合理治疗和对中重度和治疗效果不佳的结核性脑膜炎适时的鞘内注药可改善患者的预后。患者的体质同预后有关。

    Release date:2016-09-08 09:54 Export PDF Favorites Scan
  • 口服乙胺丁醇疑致皮肤色素沉着一例

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  • 可来福接头在结核性脑膜炎患者输注甘露醇中的应用及效果

    目的探讨可来福(无针输液)接头在结核性脑膜炎患者输注甘露醇中的应用及效果。 方法将2012年7月-2014年1月输注甘露醇治疗的112例结核性脑膜炎患者采用抽签法随机分为试验组和对照组,每组各56例。两组患者输液时均采用中国洁瑞公司生产的24G安全留置针,试验组使用可来福接头,对照组采用普通肝素帽接9号头皮针,对比两组在输入甘露醇时留置针输液速度、回血、堵管、静脉炎、输液管脱落等情况。 结果试验组与对照组的输液时间分别为(9.52±1.32)、(13.02±2.08)min,试验组发生回血、堵管、静脉炎、输液管脱落的患者例数分别为6、5、4、0例,对照组分别为22、17、15、10例,组间差异均有统计学意义(P<0.01)。 结论结核性脑膜炎患者在输注甘露醇时宜选用可来福接头。

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  • 结核性脑膜炎的诊治进展

    结核性脑膜炎(TBM)是最常见的中枢神经系统结核病,其发病率和死亡率均较高。TBM的临床表现缺乏特异性,实验室检查敏感性不足,因此其诊断仍较困难。此外,随着结核杆菌耐药及人类免疫缺陷病毒的合并感染的增多,TBM的治疗亦受到极大挑战。近年来关于TBM的诊治有一些新的研究进展,现综述如下。

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  • Analysis of the Curative Effect and Prognosis of 32 Cases of Drug Resistant Tuberculosis Meningitis

    ObjectiveTo analyze the curative effect and prognosis of drug resistant tuberculosis meningitis (TBM). MethodsRetrospective analysis was carried out on the clinical data of thirty-two cases of drug resistant tuberculous meningitis patients hospitalized from January 2010 to December 2015. And the prognosis of the patients was evaluated by meliorated Rankin Scale (mRS). ResultsThirty-one cases (96.9%) were improved in 32 patients with drug resistant TBM, and 1 case (3.1%) was ineffective. After treatment, one patient had hormone-related glaucoma and osteoporosis, and one patient had drug Cushing syndrome. Twenty-seven patients (84.4%) had an mRS score equal to or less than 2 points. ConclusionDrug resistant TBM is difficult to diagnose in the early stage, and the curative effect is satisfying with active anti-tuberculosis treatment.

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  • 神经系统相关慢病的临床研究

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  • Primary Extensively Drug-Resistant Tuberculosis Meningitis:One Case Report and Literature Review

    Objective To investigate the clinical manifestations,diagnosis and treatment of extensively drug-resistant tuberculosis (XDR-TB)meningitis. Methods One case of primary tuberculousis meningitis infected with multidrug-resistant mycobacteria was analyzed retrospectively.Relevant literatures were also reviewed by retrieving information through Wanfang Database and Pubmed using key words "multiple drug resistant tuberculosis meningitis","MDR tuberculosis meningitis","multiple drug resistant TBM","mul-drug resistant tuberculous meningitis","extensively drug resistant tuberculosis meningitis","XDR TBM","extensively drug resistant TBM" both in Chinese and English. Results A 24-year-old male patient,complained of headache,vomiting for 5 days,aggravated with mental abnormalities for 10 hours,with no history of pulmonary tuberculosis,was hospitalized in the Affiliated Hospital of Zunyi Medical College.The chest plain film was normal.Craniocerebral CT scan showed mild-hydrocephalus and cisterna ambiens stenosis.The patient died after undergoing anti-TB treatments with isoniazid(INH)0.3g iv qd,INH 0.3g po qd,rifampicin(RFP)0.45g qd,pyrazinamide(PZA)1.5g qd,ethambutol(EMB)0.75g qd,and dexamethasone(DEX)15mg qd.He was diagnosed as XDR-TB meningitis(as drug-resistant to isoniazid,rifampicin,streptomycin,ciprofloxacin,paminosalicylic acid,kanamycin,and protionamide ).Mycobacteria tuberculosis was isolated from his cerebrospinal fluid after 3 months.Five cases in 4 literatures were retrieved through Wanfang database and Pubmed among which 2 cases were initial treated,3 cases was unknown about initial treatment or re-treatment. Conclusions XDR-TB meningitis is rare in clinical practice with serious condition,rapid progress and high mortality rate.It is necessary to acquire drug susceptibility test results as soon as possible and adjust treatments according different conditions.A molecular drug susceptibility test may be helpful in the future.

    Release date:2016-10-12 10:17 Export PDF Favorites Scan
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