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目的 探讨颅内感染 (ICI)患者脑膜刺激征 (MIS)阴性的相关因素及其机理和临床意义。方法对 40 9例确诊的ICI患者MIS检出状况及相关临床资料进行回顾性分析。结果 本组病例的MIS阴性率为14 9% (6 1/4 0 9)。MIS阴性率 :脑实质病变组较脑膜病变组高 (P <0 .0 1) ;意识障碍组较清醒组高 (P <0 .0 1) ;病理征阳性组较病理征阴性组高 (P <0 .0 1) ;首诊时间 <2天组较 >2天组高 (P <0 .0 5 ) ;儿童及老年组较青壮年组高 (P <0 .0 5 ) ;查体者资历 <5年组较 >5年组高 (P <0 .0 5 )和非神经科专业组较神经科专业组高(P <0 .0 5 )。结论 病变部位、意识状态的不同以及有无病理征为影响ICI患者MIS检出的非常重要的相关因素 ;患者的首诊时间及年龄、医生的资历和专业的差异也是重要的相关因素。
Objective To explore the related factors and its mechanism and clinical significance of negative meningeal irritation (MIS) in patients with intracranial infection (ICI). Methods Retrospective analysis was performed on MIS detection status and related clinical data of 40 9 ICI patients diagnosed. Results The negative rate of MIS in this group was 14 9% (6 1/4 0 9). The MIS-negative rate was significantly higher in patients with brain parenchyma than in patients with meningeal lesions (P <0.01). The disturbance in consciousness group was higher than that in awake group (P <0.01) <0. 01). The first visit time was lower in the 2-day group than in the 2-day group (P <0.05), while the children and the elderly group were higher than those in the young group (P <0. 05) The qualifications were lower in the 5-year group than in the 5-year group (P <0.05) and in the non-neurological group as compared with the neurology group (P <0. 05). Conclusions The location of lesions, the different status of consciousness and the presence or absence of pathological sign are the most important related factors that affect the detection of MIS in ICI patients. The time and age of first visit, the qualifications of doctors and the professional differences are also important related factors.