腰大池腹腔分流术治疗艾滋病并发新型隐球菌性脑膜炎所致非脑积水性高颅压12例分析  

Analysis of 12 cases of non-hydrocephalus high intracranial pressure of lumboperitoneal shunt in the treatment of non AIDS patients with cryptococcus neoformans meningitis

作　　者：曹杨[1] 王清河[1] 冯恩山[1] 李培亮[1] 李延滨[1] 孙际典 

机构地区：[1]首都医科大学附属北京地坛医院神经外科,100015

出　　处：《疑难病杂志》2015年第12期1225-1227,共3页Chinese Journal of Difficult and Complicated Cases

基　　金：首都临床特色应用研究项目(No.Z121107001012109)

摘　　要：目的分析腰大池腹腔分流术治疗艾滋病并发新型隐球菌性脑膜炎所致非脑积水性高颅压的临床特点及治疗情况。方法 2011年10月—2014年12月共收治艾滋病并发新型隐球菌性脑膜炎所致非脑积水性高颅压患者12例,经内科保守治疗降颅压无效,应用腰大池腹腔分流术并同时予以正规抗真菌治疗,对其疗效进行随访。结果 12例患者中男11例,女1例,年龄18~45岁,中位年龄26岁,病程3 d^1个月。12例患者均表现为高颅压症状,其中头痛10例,头晕8例,恶心、厌食8例,频繁呕吐1例,复视2例,听力下降3例,视力下降8例,间歇性中、低热8例,精神症状1例。经腰大池腹腔分流术治疗后,高颅压症状消失9例,改善3例,未造成新型隐球菌感染扩散。结论腰大池腹腔分流术可以显著改善艾滋病并发新型隐球菌性脑膜炎所致非脑积水性高颅压患者的临床症状。Objective To analyzes the lumboperitoneal shunt in the treatment of AIDS complicated with cryptococcus neoformans meningitis caused by non-hydrocephalus high intracranial pressure.Methods From October 2011 to December2014,12 AIDS patients complicated with new cryptococcus neoformans meningitis caused by non-hydrocephalus and increased intracranial pressure were enrolled,with medical conservative treatment to reduce intracranial pressure invalid,used lumboperitoneal shunt for treatment and at the same time with regular anti fungal treatment,the curative effect were followed up.Results 12 patients were 1 1 males and 1 female,aged 18 to 45 years,median age was 26 years old,the course of disease was3 d to 1 month.12 cases were found with increased intracranial pressure symptoms,among them,10 cases with headache,dizziness in 8 cases,8 cases with anorexia and nausea,frequent vomiting in 1 cases,diplopia in 2 cases,hearing loss in 3 cases,decreased visual acuity in 8 cases;8 cases with intermittent,median or low fever;psychiatric symptoms in 1 case.After lumbar peritoneal shunt treatment,high intracranial pressure symptoms disappeared in 9 cases,3 cases were improved,and without causing cryptococcus neoformans infection spread.Conclusion Lumboperitoneal shunt can significantly improve clinical symptoms of AIDS patients complicated with cryptococcus neoformans meningitis caused by non-hydrocephalus high intracranial pressure.

关 键 词：艾滋病 新型隐球菌性脑膜炎 腰大池腹腔分流术 非脑积水性高颅压 

分 类 号：R651.1[医药卫生—外科学]