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本文对1977～1987年4月收住的19例结脑误诊病例进行分析,分别误诊为上感、化脓性脑膜炎、败血症、伤寒、病脑、流行性脑脊髓膜炎、胸膜炎、肺炎、营养不良及尿路感染等。对误诊原因进行了讨论,提出了避免误诊的措施。结核性脑膜炎(简称结脑)早期极易误诊。我院1977～1987年4月收住而资料较完整的结脑共54例,其中19例误诊为各种疾病。就误诊情况及教训分析如下。临床资料一、一般资料男12例,女7例。年龄5月～62岁,平均21.42岁,其中儿童8例,成人11例,50岁以上者1例。二、症状和体征头痛10例,呕吐6例,发热14例,以37.5～38.5℃为多,超过39℃者仅2例。头痛、呕吐及发热并存者仅4例。抽搐、惊厥或昏迷者4例。颈项强直10例,克氏征或/和布氏征阳性5例,巴氏征阳性2例。
In this paper, from April 1977 to April 1977, 19 cases of misdiagnosed tuberculous meningitis were analyzed, which were misdiagnosed as upper extremity, purulent meningitis, septicemia, typhoid fever, sick brain, epidemic cerebrospinal meningitis, pleurisy, pneumonia, nutrition Bad and urinary tract infections. The causes of misdiagnosis were discussed, and measures to avoid misdiagnosis were put forward. Tuberculous meningitis (referred to as knot brain) easily misdiagnosed early. Our hospital from 1977 to April 1987 admitted to a more complete data of the brain knot a total of 54 cases, of which 19 cases misdiagnosed as various diseases. Misdiagnosis and lessons learned as follows. Clinical data First, the general information of 12 males and 7 females. The age ranged from May to 62 years old, with an average of 21.42 years old, including 8 children, 11 adults and 1 case over 50 years old. Second, the symptoms and signs of headache in 10 cases, vomiting in 6 cases, fever in 14 cases, 37.5 ~ 38.5 ℃ for more than 39 ℃ were only 2 cases. Headache, vomiting and fever coexist only 4 cases. Convulsions, convulsions or coma in 4 cases. 10 cases of neck stiffness, Kirschner sign or / and Buchner sign positive in 5 cases, Pakistan sign positive in 2 cases.