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4种脑膜炎的临床鉴别诊断分析 被引量:4

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摘要 目的探讨病毒性脑膜炎、化脓性脑膜炎、隐球菌性脑膜炎和结核性脑膜炎的临床表现、脑脊液、外周血象和神经影像学鉴别要点。方法回顾性分析我科收治的164例脑膜炎患者,其中病毒性脑膜炎106例、化脓性脑膜炎24例、隐球菌性脑膜炎11例和结核性脑膜炎23例,对4种脑膜炎的一般资料、临床表现、脑脊液、外周血象以及神经影像学资料进行比较。结果病毒性脑膜炎所占比例最大,发病年龄最小,意识障碍发生率最低,脑脊液葡萄糖和氯化物接近于正常,颅脑CT或MRI异常率最低;化脓性脑膜炎的体温最高,脑脊液蛋白和细胞最高,且以多核细胞为主,血白细胞升高最明显;隐球菌性脑膜炎肢体无力和视力下降的发生率最高,脑脊液压力最高;结核性脑膜炎除了有低热、盗汗、消瘦等结核特有体征,有神经系统外结核病灶,脑脊液抗酸染色查到抗酸杆菌,脑脊液中发现结核分枝杆菌,有结核病密切接触史,经正规抗结核治疗1个月以上有效以外,未发现其完全区别于其他3种脑膜炎的临床特点。结论根据临床表现、脑脊液和外周血象可初步鉴别这4种脑膜炎,影像学可提供脑膜、脑室或脑实质受累的依据。
出处 《福建医药杂志》 CAS 2013年第2期44-47,共4页 Fujian Medical Journal
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参考文献7

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