可调压分流管在合并颅内高压的新型隐球菌性脑膜炎治疗中的应用  

Application of adjustable pressure shunt tube in the treatment of Cryptococcus neoformans meningitis with intracranial hypertension

作　　者：廖佳奇 许金仙[2] 张震宇[1] LIAO Jiaqi;XU Jinxian;ZHANG Zhenyu(Department of Neurosurgery,Ganzhou People's Hospital,Jiangxi Province,Ganzhou341000,China;School of Nursing,Gannan Medical College,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省赣州市人民医院神经外科,江西赣州341000 [2]赣南医学院护理学院,江西赣州341000

出　　处：《中国当代医药》2024年第3期88-91,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212454)。

摘　　要：目的研究可调压分流管在合并颅内高压的新型隐球菌性脑膜炎治疗中的应用。方法选取2020年7月至2022年12月于赣州市人民医院就诊的40例合并颅内高压的新型隐球菌性脑膜炎患者作为研究对象,按照随机数字表法将其分为试验组(n=20)和对照组(n=20)。试验组采用抗真菌药物+可调压分流管实施脑室腹腔分流术治疗,对照组采用抗真菌药物+固定压分流管实施脑室腹腔分流术治疗。比较两组患者的临床疗效、住院天数、抗真菌药物使用天数、治疗前及治疗1周后两组患者的临床指标(颅内压、脑脊液隐球菌数)水平、引流术后并发症(硬脑膜下出血、脑室外出血、颅内感染)发生率。结果试验组患者的疗效优于对照组,差异有统计学意义(P<0.05)。试验组患者的住院天数和抗真菌药物使用天数短于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的颅内压和脑脊液隐球菌数比较,差异无统计学意义(P>0.05);治疗1周后,两组患者的颅内压和脑脊液隐球菌数均低于治疗前,且试验组低于对照组,差异有统计学意义(P<0.05)。试验组硬脑膜下出血发生率低于对照组,差异有统计学意义(P<0.05);两组患者的脑室外出血、颅内感染发生率比较,差异无统计学意义(P>0.05);试验组的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论可调压分流管可有效改善合并颅内高压的新型隐球菌性脑膜炎患者的临床症状,有效控制颅内压力,缩短治疗周期,并提高其临床治愈率,降低其并发症发生率,利于其预后康复。Objective To study the application of adjustable pressure shunt tube in the treatment of Cryptococcus meningitis with intracranial hypertension.Methods Forty patients with Cryptococcus meningitis complicated with intracranial hypertension treated in Ganzhou People's Hospital from July 2020 to December 2022 were selected as the study objects,and were divided into experimental group(n=20)and control group(n=20)according to random number table method.The experimental group received ventriculoperitoneal shunt treatment with antifungal drugs+adjustable pressure shunt tube,and the control group received ventriculoperitoneal shunt treatment with antifungal drugs+fixed pressure shunt tube.The clinical efficacy,hospitalization days,antifungal drug use days,clinical indicators(intracranial pressure,cryptococcus count in cerebrospinal fluid)before treatment and 1 week after treatment,incidence of postoperative complications(subdural hemorrhage,extraveicular blood,intracranial infection)between the two groups were compared.Results The therapeutic effect of experimental group was better than that of control group,and the difference was statistically significant(P<0.05).The days of hospitalization and the days of antifungal drug use in experimental group were shorter than those in control group,and the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in intracranial pressure and the number of Cryptococcus in cerebrospinal fluid between the two groups(P>0.05).After 1 week of treatment,the intracranial pressure and the number of Cryptococcus in cerebrospinal fluid in the two groups were lower than before treatment,and the experimental group was lower than the control group,with statistical significance(P<0.05).The incidence of subdural hemorrhage in experimental group was lower than that in control group,and the difference was statistically significant(P<0.05).There were no significant differences in the incidence of external ventricular blood and intracranial infection betw

关 键 词：可调压分流管 合并颅内高压 新型隐球菌性脑膜炎 抗真菌药物 脑室腹腔分流术 

分 类 号：R519.4[医药卫生—内科学]