摘要
目的:分析中枢神经系统感染患者的临床特征,并提出适当的治疗对策。方法:选取2007年1月—2012年12月期间以发热待查收治入院的中枢神经系统感染患者97例病例资料,其类型为病毒性脑膜炎48例、结核性脑膜炎28例、化脓性脑膜炎12例和隐球菌性脑膜炎9例,分析和比较这4种脑膜炎患者的一般资料、临床表现以及脑脊液(CSF)和外周血象的变化情况。结果:97例中枢神经系统感染患者中,病毒性脑膜炎患者所占比例高于其他类型脑膜炎(P<0.05),其患者发病年龄低于其他类型(P<0.01),患者意识障碍的发生率低于其他类型(P<0.05),其CSF葡萄糖和氯化物值接近正常;化脓性脑膜炎患者的体温高于其他类型(P<0.01),其发生意识障碍、颈项强直及病理征阳性率高于其他类型(P<0.01),其血白细胞(WBC)计数、CSF细胞数均高于其他类型(P<0.01),且其CSF细胞以多核细胞为主;隐球菌性脑膜炎患者的发病年龄高于其他类型(P<0.01),其热程长于其他类型(P<0.01),热程时间低于其他类型(P<0.01),患者视物模糊的发生率高于其他类型(P<0.01);结核性脑膜炎患者的CSF蛋白定量高于其他类型(P<0.01),其氯化物含量低于其他类型(P<0.01)。结论:根据各类脑膜炎患者的临床表现、CSF和外周血象检查结果,按不同类型的脑膜炎采用不同的抗菌药物治疗。
Objective： To analyze the clinical characteristics in 97 patients with central nervous system infection and to take appropriate treatment countermeasure. Methods： 97 patients with central nervous system infection chosen during January 2007 to December 2012 for fever thesis were retrospective analyzed, among whom viral meningitis were 48 cas- es, tuberculous meningitis were 28 cases, purulent meningitis were 12 cases, and cryptococcus meningitis were 9 cases. The 4 types meningitis patients＇ general information, clinical manifestation, cerebrospinal fluid（CSF） and peripheral blood test results were analysed and compared. Results： Among 97 patients with central nervous infection, the propor- tion of viral meningitis patients＇ was significantly higher tharf others（P〈0.05）, whose onset age and consciousness distur- bance were significantly lower than other patients（P〈0.01 ）, and CSF glucose and chloride content were close to normal. Purulent meningitis patients＇ body temperature,consciousness disturbance,neck stiffness and pathologic characteristic positive ratio, blood WBC and CSF cells number were significantly higher than other types（P〈0.01）, and their CSF cells were dominated by multicore cells. Cryptococcus meningitis patients＇ onset age was significantly higher than other types （P〈0.01）, whose thermal process was significantly longer than others（P〈0.01）, and their temperature was significantly lower than other types（P〈0.01）; however their blurred vision incidence was significantly higher than others（P〈0.01）. Tuberculous meningitis patients＇ CSF protein quantitative was obviously higher than that of other types（P〈0.01） and their CSF chloride was significantly lower than others（P〈0.01）. Conclusion： Based on the clinical manifestations, CSF and peripheral blood imaging results of various meningitis patients, different types of meningitis are treated with differ- ent antimicrobial agents.
出处
《抗感染药学》
2017年第5期968-971,共4页
Anti-infection Pharmacy
