化疗后骨髓抑制期发生鼻脑曲霉菌病——一例报告附文献复习  

Invasive rhinocerebral aspergillosis occurred during myelosuppressive phase after chemotherapy : a case report and literature review

作　　者：俞志勇[1] 陈虎[1] 江岷[1] 杨树军 胡亮钉[1] 

机构地区：[1]军事医学科学院附属医院造血干细胞移植中心,北京100039

出　　处：《中华血液学杂志》2001年第7期366-369,共4页Chinese Journal of Hematology

摘　　要：目的　报道 1例急性髓系白血病 (AML) M2a患者化疗后骨髓抑制期发生侵袭性鼻脑曲霉菌病 (invasiverhinocerebralaspergillosis,IRA)及其治疗经过 ,并进行文献复习。方法　 1例AML M2a患者 ,化疗后骨髓抑制期发生IRA ,连续给予两性霉素B(AmB) ,包括脂质体AmB治疗 ,同时给予大蒜素、5 氟胞嘧啶 (5 FC)、氟康唑、伊曲康唑、酮康唑、益康唑及制霉菌素等联合治疗 ,并先后 2次行开颅病灶切除、减压术。结果　经过上述治疗 ,患者生存时间虽略有延长 ,但最终仍因感染无法彻底控制而死亡。结论　对于大部分IRA目前尚无特效治疗措施 ,AmB也仅对少部分患者有效 ,结合手术切除病灶是目前为止最佳的治疗方法。Objective To report a case of invasive rhinocerebral aspergillosis(IRA) during myelosuppressive phase after chemotherapy and the treatment outcome. Methods A patient with acute non lymphoblastic leukemia(M 2a ) occurred IRA during myelosuppressive phase after chemotherapy and was treated with amphotericin B(AmB,including AmB L),garlicin,5 flucytosine(5 FC),fluconazole,itraconazole,ketoconazole,econazole and griseofulvin with twice of cerebrotomy lesion resections and cerebral decompressions. Results Though the survival time of this patient is a little longer than the others, she finally died of uncontrolled infection. Conclusion For most of the IRA, there remains no effective treatment. The best treatment is AmB in combination with surgical excision.

关 键 词：曲霉病 两性霉素B 病灶切除术 

分 类 号：R730.53[医药卫生—肿瘤]