Lobzin V S, Al'tfel'd Iu S, Lobzin Iu V
Zh Nevropatol Psikhiatr Im S S Korsakova. 1976 Sep;76(9):1304-10.
The authors convened a special study for purposes of determining early signs of epidemic cerebrospinal meningitis and for the dependence of the prognosis from early etiotropic and pathogenetic therapy. On the basis of a study of 93 cases criteria of early diagnosis are being given. Unlike the data in literature, in 60.2% of the cases it was possible to initiate treatment during the first hours of the disease and in 94.6% -- not later than 48 hours. In most of the cases the disease had a grave course. Changed consciousness was observed in 55.9%, an increased amount of protein in the CSF -- in 58%. In 8 cases there was a syndrome of acute renal insufficiency. Despite these facts all the patients recovered. The authors come to the conclusion that prognosis may be significantly improved in cases of early diagnosis (during the first hours), intensive penicillin therapy (both intravenously and kanamicin into the carotid artery). The authors suggest that during reconvalescence it is feasible to prescribe resolving (pyrogenal lydase) and general therapy.
作者们开展了一项专项研究，目的是确定流行性脑脊髓膜炎的早期症状，以及早期病因特异性和致病性治疗对预后的影响。基于对93例病例的研究，给出了早期诊断标准。与文献数据不同的是，60.2%的病例能够在疾病的最初数小时内开始治疗，94.6%的病例不迟于48小时开始治疗。大多数病例病情严重。55.9%的患者出现意识改变，58%的患者脑脊液中蛋白质含量增加。8例患者出现急性肾功能不全综合征。尽管如此，所有患者均康复。作者们得出结论，在早期诊断（最初数小时内）、强化青霉素治疗（静脉注射及颈动脉注射卡那霉素）的情况下，预后可能会显著改善。作者们建议，在康复期，开具消散（热原溶解酶）和一般治疗药物是可行的。
