【作者】 李淑艳； 刘国利； 吴海良； 战云飞； 杨效光；

【Author】 Li Shuyan,Liu Guoli,Wu Hailiang,Zhan Yunfei,Yang Xiaoguang (Shandong Provincial Chest Hospital,Jinan,250013)

【机构】 山东省胸科医院；

【摘要】 目的探讨晚期重症结核性脑膜炎有效的治疗方法。方法在正规全身使用抗结核药物、激素和脱水剂等基本疗法的基础上,采用脑脊液置换综合给药疗法进行治疗。具体方法是缓慢放出脑脊液,再缓慢注入生理盐水,反复进行2-4次;然后注入异烟肼和氟美松,合并梗阻者可注入无菌过滤空气;随着症状缓解,逐渐减少给药次数,直至脑脊液恢复正常。结果 38例重症晚期结核性脑膜炎应用脑脊液置换配合鞘注的方法,最少7次,最多28次,平均16次,均无不良反应,治愈36例,明显好转2例,无一例死亡。结论本疗法可改善脑脊液循环,缓解结脑的症状,临床疗效满意。同时清除脑脊液蛋白,防止粘连,降低颅压,防止脑疝,减少后遗症和降低病死率等方面均有一定的临床意义。此疗法对于治疗晚期重症结脑,是一种简单、有效和安全的方法,值得在临床中推广应用。更多还原

【Abstract】 Objective To explore effective therapy for treating terminal serious tuberculous meningitis.Methods Base on the regular treatment such as anti-tuberculosis drugs,hormone and dehydration preparation,used cerebrospinal fluid(CSF) replacement combined with intrathecal comprehensive therapy.The method is following:First take slowly CSF,then inject 0.9%NaCl then take slowly CSF,repeat it 2 4times then inject INH and Dexamethasone to inject the sterile filtrated air for the patient with obstruction to reduce the injective times with symptom amelioration,until CSF recovered normal.Results The treatment average times are 16(7-28 times).The patients have not any side effect for the 38 cases with terminal serious tuberculous meningitis used cerebrospinal fluid(CSF) replacement combined with intrathecal comprehensive therapy;cured 36 cases obvious amelioration 2 cases,no died cases.Conclusion The therapy can improve circulation of CSF,relieve patient symptoms,and got the satisfactory clinic efficacy.Meanwhile clean out protein of CSF to prevent the conglutination;to drop the intra-cerebral pression to reduce the encephalocele sequelae and fatality rate.The therapy is a simple,effective and safety,and can be used widely in clinic treatment for the patients of terminal serious tuberculous meningitis.更多还原