耐多药结核性脑膜炎4例临床疗效分析并文献复习  

Analysis on clinical efficacy of four cases with multidrug-resistant tuberculous meningitis and literatures review

作　　者：陈志成[1] 方毅敏[1] 陈永浩[1] 董海平[1] 

机构地区：[1]广州市胸科医院,广州510095

出　　处：《中国防痨杂志》2011年第8期500-504,共5页Chinese Journal of Antituberculosis

摘　　要：目的探讨耐多药结核性脑膜炎的治疗方法、方案的组合、疗程并进行疗效判断。方法回顾广州市胸科医院近年收治的4例脑脊液培养有耐多药抗酸杆菌生长的结核性脑膜炎患者状况,进行临床疗效分析并文献复习。结果经个体化的抗结核治疗方案,联合鞘内注射异烟肼等措施,其中2例患者治愈停药。另2例患者因出现严重并发症或药物不良反应、救治无效而死亡。结论耐多药结核性脑膜炎病情重、进展快、病死率高。目前,临床尚无统一的治疗方案。Objective To investigate the antituberculosis therapeutic methods,regimen,course and efficacy judgment for multidrug-resistant tuberculous meningitis. Methods Four tuberculous meningitis cases with multidrug-resistant tuberculosis isolated from cerebrospinal fluid were analyzed retrospectively in our hospital in recent years and relevant literatures were reviewed. Results Four patients were treated with individual anti-TB therapeutic regimen and combined with intrathecal injection with isoniazid and dexamethasone.Two patients had been cured and drug withdrawal and the others were dead due to serious complications or adverse drug reaction. Conclusion Tuberculous meningitis cases with multidrug-resistant tuberculosis usually are serious disease,rapid deterioration and high mortality.There is no uniform therapeutic regimen to treat at present.

关 键 词：结核 脑膜/药物疗法 抗药性 多种 细菌 治疗结果 

分 类 号：R529.3[医药卫生—内科学]