静脉联合鞘内应用两性霉素B治疗隐球菌性脑膜炎23例的不良反应及疗效观察  

To study the effect and untoward reaction with Amphotericin B to cryptococcal meningitis through intratheca and veins

作　　者：韦继政[1] 李素珍[1] 吕小亮[2] 

机构地区：[1]暨南大学医学院第六附属医院神经内科,广东江门529031 [2]暨南大学医学院第六附属医院恩平分院,广东恩平529400

出　　处：《蛇志》2006年第2期107-110,共4页Journal of Snake

摘　　要：目的探讨静脉联合鞘内应用两性霉素B(AmB)治疗隐球菌性脑膜炎(隐脑)的疗效及发生的不良反应。方法回顾性分析应用AmB治疗23例隐脑疗效及各种不良反应,以及不良反应的防治措施。结果23例患者静脉联合鞘内应用AmB治愈率78.3%,治疗过程中有20例发生各种不良反应,包括即刻反应、血细胞异常减少、肝肾功能损害、心脏毒性、低钾血症及静脉炎。其中以肾、肝功能损害及低钾血症最为多见,其发生比率分别为43.6%、40.0%、38.2%。结论静脉早期联合鞘内应用AmB治疗隐脑疗效明显,在长程治疗中会出现各种不良反应,应密切观察病情变化,定期随访,及时防治不良反应的发生。Objective To study the effect and untoward reaction with Amphotericin B to cryptococcal meningitis through intratheca and veins. Methods 23 cases of cryptococcal meningitis are treated with Amphotericin B and analyse the untoward reactions and controlling ways. Results The recovering rate is 78.3 with untoward reactions in 20 cases, including immediate reaction, reducing of blood cells, decreasing of liver and kidney functions, toxicity to heart, kaliopenia, and phlebitis. Its rate is 43.6%, 40.0%,38.2% in decreasing of liver and kidney functions, kaliopenia. Conclusion There is significant effect and untoward reaction in cryptococcal meningitis cases with Amphotericin B through veins and intratheca. Untoward reactions are controlled timely through observing the changes of disease and visiting on time.

关 键 词：两性霉素B 不良反应 隐球菌性脑膜炎 

分 类 号：R519.4[医药卫生—内科学]