腰大池置管治疗艾滋病合并新生隐球菌性脑膜炎疗效评价  

Evaluation of drainage CSF via lumbar catheter in the treatment of cryptococcal meningitis with AIDS

作　　者：杨萱 孙燕 刘春礼 刘旭辉 张洪新 侯明杰 赵清霞 

机构地区：[1]河南省传染病医院,郑州450006

出　　处：《中国实用神经疾病杂志》2011年第5期27-29,共3页Chinese Journal of Practical Nervous Diseases

基　　金：2008年郑州市科技攻关项目(2008ZX10001-017-04)

摘　　要：目的观察与评价腰大池置管持续引流治疗艾滋病合并新生隐球菌性脑膜炎患者的疗效。方法对12例艾滋病合并新生隐球菌性脑膜炎顽固性高颅压患者采用腰大池置管持续引流同时给予两性霉素-B、氟康唑、5-氟胞嘧啶等抗真菌治疗,定期复查脑脊液常规、生化,脑脊液墨汁染色查隐球菌,观察临床症状改善情况,记录拔管时间。结果经腰大池置管持续引流后,患者头痛、呕吐、意识障碍等症状逐渐减轻,合并视盘水肿的患者得到明显改善。经联合治疗好转9例,死亡3例。结论腰大池置管持续引流能有效降低患者的颅内压,改善临床症状,为抗真菌治疗争取时间。Objective To observe and evaluate the effect of drainage CSF via lumbar catheter in cryptococcal meningitis with AIDS.Methods Twelve cases of refractory elevated intracranial pressure in cryptococcal meningitis with AIDS were treated by continuous drainage CSF via lumbar catheter combined with antifungal therapy which fluroconazole,amphotericin B combined with 5-FC were used.CSF routine,biochemical test and india ink staining were observed on regular-examination,changes of clinical symptoms and extubation time were recorded.Results Headache,vomit,loss of consciousness in 10 cases reduced gradually,papilloedema in 5 cases improved significantly after drainage CSF via lumbar catheter.Nine patients improved and 3 died after combined treatment.Conclusion The treatment of drainage CSF via lumbar catheter can reduce effectively intracranial hypertension and improve symptoms,can strive for the time of anti-fungus treatment.

关 键 词：艾滋病 隐球菌脑膜炎 颅高压 腰大池引流 

分 类 号：R512.91[医药卫生—内科学]