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结核性脑膜炎(简称结脑)在我国病死率仍较高,达20%左右,其原因与误诊率高有密切关系.本文就我院1980～1985年间住院结脑病人中误诊的105例进行分析.临床资料一、病例选择:自结脑发病始1周内确诊者为早期诊断,超过此标准者为误诊.以此选择住院3个月以上、资料较完整、治疗方案基本相同的病人247例,误诊者105例(42.5%),误诊时间6～68天,平均24.5天.二、一般资料:城镇居民32例;农民73例.男38例,女67例.年龄2～58岁,平均25.4岁.有结核病密切接触史者35例,结核病史者12例,合并原发结核病11例,合并栗粒型结核62例,未查出合并结核者7例.以发热、头痛急性起病者81例,起病缓慢、症状不典型者24例.58例为中晚期结脑,未确诊之前均不同程度地用过抗生素.三、误诊的疾病:见表1.
Tuberculous meningitis (referred to as tuberculous meningitis) in our country, the mortality rate is still high, about 20%, the reason and the misdiagnosis rate is closely related to this article on our hospital from 1980 to 1985 inpatients with tuberculous meningitis in 105 cases Analysis of clinical data A case selection: from the onset of the brain onset within 1 week for the early diagnosis of diagnosis, more than this standard for misdiagnosis.To choose more than 3 months hospitalization, more complete information, the same treatment program for patients 247 Cases, misdiagnosis in 105 cases (42.5%), misdiagnosis time 6 to 68 days, an average of 24.5 days. Second, the general information: 32 urban residents, 73 farmers, 38 males and 67 females, aged 2 to 58 years, An average of 25.4 years old .There were 35 cases of close contact history of tuberculosis, 12 cases of history of tuberculosis, 11 cases of primary tuberculosis combined with chestnut tuberculosis in 62 cases, not found in 7 cases of tuberculosis.Acute fever, headache acute onset 81 cases, slow onset, atypical symptoms in 24 cases .58 cases of advanced tuberculous, were not diagnosed before varying degrees of antibiotics were used. Third, the misdiagnosis of the disease: Table 1.