河北医大二院住院的中枢神经系统感染的现状分析

发布时间：2018-06-12 07:28

本文选题：中枢神经系统感染 + 病毒性脑炎　；参考：《河北医科大学》2012年硕士论文

【摘要】：目的：中枢神经系统感染是指脑实质和脊髓及其被膜和血管等受到病源微生物（包括细菌、真菌、病毒、螺旋体、寄生虫、立克次体和朊蛋白等）的侵袭而发生的急性或慢性炎症性疾病，是神经系统的常见疾病之一。我国每年中枢神经系统感染的发病人数超过百万例，其患者病死率高，并可造成严重的神经系统后遗症，是严重威胁人类健康的感染性疾病。病毒性脑膜炎或脑炎(简称病脑)、化脓性脑膜炎(简称化脑)、结核性脑膜炎(简称结脑)、隐球菌性脑膜炎(简称隐脑)以及脑囊虫病是临床上常见的类型。基于这一现状，关于中枢神经系统感染的流行分布情况的研究日益增多，但多集中于对某一种病原体进行研究，缺乏全面的流行病学分布特点总结。而石家庄地区中枢神经系统感染方面的文献资料则更为缺乏。本文通过分析9067例患者的临床资料，旨在了解石家庄地区常见中枢神经系统感染性疾病的演变情况、分布情况和病原谱特点，进而总结中枢神经系统感染性疾病的发病特点、发展趋势及分布规律，从而丰富国家感染性疾病资料库，为中枢神经系统感染性疾病的研究指引方向，为防病工作提供指导。方法：对河北医科大学第二医院1996—2011年16间收治的常见中枢神经系统感染患者的临床资料进行整理。将符合条件的病例按病原种类分为病脑组、结脑组、化脑组、隐脑组、脑囊虫组五组。收集包括入院日期，出院日期，患者姓名，性别，年龄，主要诊断，主要诊断转归，其他诊断，其他诊断转归，患者职业，家庭住址等信息，并从病种分布，年度分布，季节分布，住院天数、年龄分布、性别构成、城乡分布、职业分布等方面汇总各组信息，并进行综合分析。结果：16年间我院共收治常见中枢神经系统感染性疾病的患者9067例，这其中病毒性脑（膜）炎6719例（74.10%），化脓性脑膜炎580例（6.40%），结核性脑膜炎816例（9.00%），隐球菌性脑膜炎83例（0.92%），脑囊虫病869例（9.58%）。2004—2011年，病毒性脑（膜）炎、化脓性脑膜炎、结核性脑膜炎、隐球菌性脑膜炎的病例数较前8年分别增加了219.68%、63.64%、46.53%、318.75%。脑囊虫病例数较前8年下降了52.96%。病毒性脑炎或脑膜炎主要集中在7—9月份，结核性脑膜炎集中于4—6月份。病毒性脑（膜）炎、化脓性脑膜炎均多见于10岁以下儿童，结核性脑膜炎多见于20—29岁的青年，而脑囊虫病则更多出现在10—19岁的青少年。化脓性脑膜炎与脑囊虫病男女性别差异明显分别为1.90:1、1.66:1。中枢神经系统感染性疾病主要分布在乡村，其中化脓性脑膜炎的城乡差别最为明显，农村病例占87.93%。病毒性脑（膜）炎患者职业以学生为主（33.06%），化脓性脑膜炎患者以儿童多见（58.84%），结核性脑膜炎、隐球菌性脑膜炎、脑囊虫病均多见于农民（分别为49.38%、50.91%、62.03%）。结论：近年来，中枢神经系统感染性疾病在河北省石家庄市及其周边地区有明显的增加趋势，提示临床工作者应对中枢神经系统感染性疾病的发病机制、诊断及治疗措施进行深入研究，提请有关部门加大重视力度，制定更加科学的防治策略，为防治工作提供指导。
[Abstract]:Objective: central nervous system infection is an acute or chronic inflammatory disease occurring in the brain parenchyma and spinal cord, its membrane and blood vessels, such as bacteria, fungi, viruses, heliospin, parasites, Rickettsia and prion protein, and so on. It is one of the common diseases of the nervous system. More than a million cases of infection are infected, with high mortality and severe neurological sequelae. It is an infectious disease that is a serious threat to human health. Viral meningitis or encephalitis (abbreviated brain), pyogenic meningitis (abbreviated as brain), tuberculous meningitis (abbreviated brain), cryptococcal meningitis (referred to as hidden brain). Brain cysticercosis is a common clinical type. Based on this situation, the prevalence of central nervous system infection is growing more and more, but most of them are focused on the study of a certain pathogen and lack of a comprehensive epidemiological distribution. The literature of the central nervous system infection in Shijiazhuang is more important. Lack.
By analyzing the clinical data of 9067 patients, this paper aims to understand the evolution, distribution and characteristics of the common central nervous system infectious diseases in Shijiazhuang, and then summarize the characteristics, trends and distribution rules of the infectious diseases of the central nervous system, so as to enrich the national database of infectious diseases. Guidelines for research on infectious diseases of the central nervous system provide guidance for disease prevention.
Methods: the clinical data of the common central nervous system infection in 16 Hospital of Hebei Medical University from 1996 to 2011 were arranged. The cases were divided into five groups according to the pathogenic species, including the brain group, the brain group, the brain group, the hidden brain group and the cerebral cysticercosis group. The date of admission, the date of discharge, the name of the patient, the sex, and the year were collected. Age, the main diagnosis, main diagnosis, other diagnosis, other diagnosis, other diagnosis, career, home address and other information, and from the disease distribution, annual distribution, seasonal distribution, the number of days in hospital, age distribution, gender composition, urban and rural distribution, occupational distribution and other aspects of the summary of the information, and comprehensive analysis.
Results: in 16 years, 9067 cases of common central nervous system infection were treated in our hospital, including 6719 cases (74.10%) of viral brain (membranous) inflammation, 580 cases of suppurative meningitis (6.40%), 816 cases of tuberculous meningitis (9%), 83 cases of cryptococcal meningitis (0.92%), 869 (9.58%) cysticercosis (9.58%),.2004 - 2011, viral brain (membranous), suppurative The number of cases of meningitis, tuberculous meningitis and cryptococcal meningitis increased by 219.68%, 63.64%, 46.53%, respectively, and the number of 318.75%. cerebral cysticercosis decreased more than the previous 8 years. 52.96%. viral encephalitis or meningitis was mainly concentrated in 7 - September. Tuberculous meningitis was concentrated from 4 to June. Viral brain (membrane) inflammation and suppurative meningitis were all More common in children under 10 years of age, tuberculous meningitis often seen in young people aged 20 to 29, while cysticercosis occurs more in adolescents aged 10 to 19. The gender differences between the sexes of purulent meningitis and cysticercosis are obviously 1.90:1,1.66:1. central nervous system infectious diseases mainly distributed in the countryside, including the urban and rural purulent meningitis. The difference was most obvious. The occupations of 87.93%. viral brain (membranous) patients in rural cases were mainly students (33.06%). The cases of suppurative meningitis were mostly seen in children (58.84%), tuberculous meningitis, cryptococcal meningitis and cysticercosis (49.38%, 50.91%, 62.03% respectively).
Conclusion: in recent years, the infectious diseases of central nervous system have obviously increased in Shijiazhuang and its surrounding areas in Hebei province. It suggests that the clinical workers should study the pathogenesis, diagnosis and treatment measures of the central nervous system infectious diseases, and ask the relevant departments to pay more attention to the prevention and treatment of the diseases. Strategy to provide guidance for the prevention and control work.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R725.1

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