流行性脑脊髓膜炎77例临床预后分析

    Prognostic features of epidemic cerebrospinal meningitis:a report of 77 cases

    • 摘要: 目的:探讨流行性脑脊髓膜炎(流脑)患者的临床特征和预后。方法:对77例流脑患者的季节分布、年龄分布、临床特征及预后、并发症进行总结,并分析实验室检查结果。结果:77例患者平均年龄为(23.96±18.21)岁。临床特点以发热、头痛、意识障碍及皮肤淤点、淤斑为主。普通型55例,暴发型22例,病死4例,未愈自动出院6例,并发弥漫性血管内凝血、休克、脑疝、呼吸衰竭等多器官功能损害者预后较差。13例细菌学培养脑膜炎奈瑟菌阳性,部分标本进行分群,其中C群7例。结论:流脑病例并发其他系统损害者多,病情较重,可能与细菌菌群变迁有关。

       

      Abstract: Objective:To investigate the prognostic features of patients with epidemic cerebrospinal meningitis. Methods:The seasonal and age distribution, the clinical features and prognosis, and the complications of epidemic cerebrospinal meningitis were analyzed among 77 patients treated in our hospital. Results:The mean age of all cases was(23.96±18.21) years old. The main clinical features were as follows:fever,headache,conscious disturbance and petechia or ecchymosis of skins. In all 77 cases,55 cases were ordinary type,and 22 cases fulminant type. Four patients died in hospital and 6 patients were discharged from hospital without recovery. The factors associated with bad outcome were DIC, shock, cerebral hernia, respiratory failure or other organ function lesions. Neisseria meningitidis were found through bacteriologic culture in 13 cases,and some were identified as serogroup C. Conclusions:Multiple organ function lesion is a significant characteristic for epidemic cerebrospinal meningitis. The symptoms of the patients are usually heavier,and it maybe was correlated with vibration of bacterial community.

       

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