(2) fundus raid: on the retina may have TB nodules need someone to answer the questions:
tuberculous meningitis nursing
No other answers best answers 1:
tuberculous meningitis is caused by the meningeal TB non-suppurative inflammation often secondary to miliary tuberculosis or tuberculosis of other organs become more common past with children, often syndrome for the lung, disseminated the results of blood or body part millet tuberculosis incidence more than half of adults to a higher prevalence of youth, but can also be found in the elderly than tuberculosis, the pivotal moment of bone tuberculosis and urogenital disseminated tuberculosis is often the source of blood in some cases may also be because the brain parenchyma or meningeal tuberculosis within the liquefied ulceration, so that a large number of M. tuberculosis into the subarachnoid space due to tuberculous meningitis, pathological changes in the pia mater and arachnoid nodule formation on tuberculosis, inflammation around the lesion and fibrin exudation, and a cheese necrosis, often most obvious in the brain at the bottom of the subarachnoid space, a large number of cloudy yellow plastic-like exudate accumulation, mainly by the size, cellulose, macrophages, lymphocytes constituted around the brain stem, may compress and damage nearby cranial nerves, causing damage response to symptoms of cranial lesions ban God who can affect cortical tension caused meningoencephalitis softening of the brain caused by multiple Erzhi prolonged course without proper treatment of cases, due to the machine of subarachnoid exudate occurred arachnoid adhesions, can under the fourth ventricle and the lateral hole in the block hole, causing the brain volume water based on clinical and pathological, can be divided into four types of tuberculous meningitis:
meningeal type: high intracranial pressure and meningeal irritation as the main performance
brain tuberculoma type : lesions in the brain parenchyma, there are signs and symptoms of cerebral localization, such as epilepsy, paralysis and other one
predominant spinal cord: this type of transition from a meningitis treated properly, there is an incidence This type of person, a spinal nerve root symptoms or partial paralysis, urinary incontinence, etc.
mixed: while this type of tumor with tuberculosis meningitis and brain-type features
history: most patients have a history of recent TB infection or TB or close contact with TB history
symptoms: often 10 to 20 days of pioneer symptoms, such as mental a vibration, general weakness, decreased food requirements, emotionally disturbed, impulsive, fever, nausea, vomiting, constipation and other gradual drowsiness, headache, heavier, and a jet of vomiting, neck stiffness, and increased intracranial pressure such as meningitis faint irritation gradually into the collapsed case all reflex, incontinence, pupil position, the pulse of growth, respiration does not rule, eventually leading to destruction
signs: body temperature more in 38 ?, miliary tuberculosis complicated with temperature can be up to 40 ? and more to the dark side (the shame out), the majority of allergic reactions in children skin punctures before the early uplift of the pupil because of photophobia Henderson narrow, late the expansion of fixed, unresponsive to light or even disappear, there may be optic nerve palsy, ptosis, double vision, stiff neck, the vast majority of patients, positive pathological reflexes, physiological reflex reduced or lost
(1) CSF raid: the pressure increased, not outside Ya colorless and transparent or frosted glass shaped, but also showed a bright yellow film for 24 hours may have increased the formation of cells and protein, sugar and chloride can reduce the TB culture positive TB increased antibody, immunoglobulin l papilledema can be determined with high intracranial pressure
(3) tuberculin test: positive reference value for the diagnosis, but the negative can not rule out the possibility of tuberculous meningitis
( 4) X ray raided: X-pulmonary primary syndrome confiscated if found, deeds of tuberculosis, miliary tuberculosis is out of line to help the diagnosis of tuberculous meningitis
(5) CT raid: to display the meninges, brain parenchyma lesions in miliary tuberculosis and caseous tumor lesions, but also shows the bottom of the exudate brain, brain edema, ventricular dilation of tuberculous
meningitis type, determine the prognosis and therapy are important
(b), prevention and prognosis
strengthen the training, health and enhance and maintain music indecent, work and rest appropriately so that righteousness strong, reduce the incidence of
active primary TB treatment, the elimination of tuberculosis, to prevent secondary infection
Vaccination: BCG vaccination, not only to prevent the occurrence of tuberculosis and vaccination in the neonatal period BCG, the incidence of tuberculous meningitis was significantly lower
nuclear already suffering from tuberculosis meningitis patients, should be hospitalized, length of stay of not less than 3 months
poor prognosis of this disease, more than 15% mortality rate is mainly determined by the prognosis is good or bad treatment of its mind sooner or later the state, with impaired consciousness, death rate was significantly higher
addition, the elderly, children perish rate also higher
the early diagnosis of tuberculous meningitis seems presumptuous of particular importance need someone to answer the questions of early diagnosis is not easy, if doctors can not be lack of experience will lead to timely diagnosis of the afternoon as a patient in case of fever, headache, vomiting, urinary retention, which are not timely to go to hospital to see a doctor as soon as possible, especially when the doctors proposed to lumbar puncture for cerebrospinal fluid raid, the dry million do not refuse, because the raid only cerebrospinal fluid in the diagnosis of the disease re-strike means, its significance sometimes more than do CT and magnetic resonance imaging raid
tuberculous meningitis is the disease can be cured, because anti-TB drugs pyrazinamide, and so can cover a great Remy to “through the blood-brain barrier”), combined with application of streptomycin, ethambutol, are generally able to obtain satisfactory results, but the amount than the treatment of pulmonary tuberculosis, treatment and long, about as big as to be two years, premature withdrawal must be easy to relapse in patients with the guidance of a doctor , the closely adhere to medication in order to complete the treatment