流行性脑脊髓膜炎重点培训.pptVIP

流行性脑脊髓膜炎 epidemic cerebrospinal meningitis;概述 病原学 脑膜炎奈瑟菌 内毒素是其重要的致病因素 可产生自溶酶 分13群：A B C D 29E H I K W135 X Y Z; ????????????????????????????????????????????????????????;流行病学 （一）传染源：病人 带菌者 （二）传播途径：呼吸道飞沫 （三）人群易感性：儿童发病率高 （四）流行特征：冬春季多发 周期性流行;;; ????????????????????????????????????????????????????????; ????????????????????????????????????????????????????????;（二）暴发型 1、休克型 fulminant meningococcal septicemia acute respiratory distress syndrome 2、脑膜脑炎型 3、混合型 （三）轻型 （四）慢性脑膜炎双球菌败血症;实验室检查 （一）血象 WBC升高 ???10～20）×109/L （二）CSF （三）细菌学检查 1、凃片 2、培养 （四）免疫学检查 特异性抗原、抗体 ;诊断; 肺炎链球菌 streptococcus pneumoniae 流感嗜血杆菌 haemophilus influenzae 金黄色葡萄球菌 staphylococcus aureus （2）结核性脑膜炎 （3）流行性乙型脑炎 2、其他病原菌引起的败血症休克;治疗;（二）暴发型的治疗 1、休克型的治疗 抗菌药 纠正休克 肾上腺皮质激素 DIC治疗 保护重要脏器功能 2、脑膜脑炎型的治疗 抗菌药 防治脑水肿、脑疝、呼吸衰竭 肾上腺皮质激素;预防;Meningococcal Infections Meningococcal infections are a major cause of mortality and morbidity in developed and developing nations. Neisseria meningitidis is the causative agent in meningococcal infections. It has become the most common cause of bacterial meningitis in American children since the use of the Haemophilus influenzae type b protein-capsular polysaccharide conjugate vaccine in infants dramatically reduced their incidence of meningitis due to this organism. Considerable progress has been made in the management and prevention of infections due to Neisseria meningitidis since the organism was first described in 1887. Because the meningococcal vaccine has limited effectiveness in the group at greatest risk to infection, ;children younger than the age of 2, meningococcal infection is still a major worldwide problem. The devastating nature of systemic meningococcal infection makes it imperative that preventive measures be developed to fully control this disease. In addition, an effective vaccine against meningococcal serogroup B infect