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小兒 結核性 腦膜炎의 臨床的 觀察

Clinical Observation of Tuberculous Meningitis in Children

부산의대잡지 1966년 6권 1호 p.177 ~ 183
최락상,
소속 상세정보
최락상 (  ) - 부산대학교 의과대학 소아과학교실

Abstract


During the last 7 years since 1957, 155 children with tuberculous meningitis have been observed. The results were as follows;
1) The statistical studies indicated that concerning the age difference, the highest incidence was noted in the group of the children from 3 to 4 years old, and numbers of the infants and .children under 6 years old were 72.9% of the total patients. Concerning sex difference, the incidence of the male patients were higher than that of the female patients at the ratio of 2:1. Concerning the seasonal difference the incidence in spring vas found to be the highest. The source of the infection was mainly familial and this was found in 31 % of the cases with the established infectious sources.
2) As the initial manifestations, vomiting and fever were complained from most of the patients. In many of the cases, it took more than 3 weeks to establish the diagnosis.
3) Concerning- the radiologic findings, 65, 8%of the cases were found to have abnormal findings in the chest X-ray pictures.
4) The effect of the chemotherapy and prognosis on the cases were analysed. Annual survival rate was slightly elevated since 1960. Concerning the age difference, the patients less than 1 year old showed the lowest rate, that was 33. 3% at present. Concerning the difference dependent on the chemotherapeutic drugs, the follow-up study indicated that a combination therapy using INH mainly with steroid hormone was best, showing the survival rate of 86%. Concerning relationship between the survival rate and the length from the onset of the disease to the starting of the treatment, the follow-up study indicated the highest rate (93.3%) in the group with treatment started within a week after the onset. The rate became remarkably low when the treatment was delayed. The survival rate was 78% in the group of the patients, who showed disturbance in the consciousness already on the admission, and 30. 8% of them developed sequelae.

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