本文選題：新型隱球菌 + 腦膜炎�。� 參考：《中國地方病防治雜志》2017年02期

【摘要】：目的探究23例新型隱球菌性腦膜炎患者的臨床特點(diǎn)及預(yù)后分析。方法選擇2013年3月至2014年12月經(jīng)本院病原學(xué)確診的23例新型隱球菌性腦膜炎患者。結(jié)果 123例患者中,12例患者為亞急性起病,11例患者為慢性起病,病程9 d至3個(gè)月不等,均出現(xiàn)了不同程度的發(fā)熱、頭痛、腦膜刺激征,所有患者HIV-Ab檢查均呈陰性;2患者病程9 d至3個(gè)月,平均病程:45.7±39.8 d;確診時(shí)間1至23 d,平均天數(shù):7.3±5.7 d;確診腰穿次數(shù)1至9次,平均次數(shù):2.3±1.7次;入院治療前被誤診為結(jié)核性腦膜炎11例,誤診為病毒性腦炎3例,誤診為狼瘡性腦病1例;323例患者均檢測到新型隱球菌感染,腦脊液墨汁染色陽性的患者17例,腦脊液培養(yǎng)出新型隱球菌19例;4顱腦影像學(xué)檢查均出現(xiàn)了不同程度的腦膜強(qiáng)化、腦積水、腦室擴(kuò)大以及肉芽腫等病變;523例患者中治愈11例,有效7例,無效3例,死亡2例,2例患者均死于多臟器功能衰竭,同時(shí)治愈患者與未治愈患者在年齡、病程時(shí)間、首次腰穿壓力值、基礎(chǔ)疾病、是否出現(xiàn)意識(shí)障礙以及腦積水方面存在明顯差異(P0.05)。結(jié)論患者年齡超過60歲,基礎(chǔ)疾病超過3種,病程≥3個(gè)月、顱內(nèi)壓超過420mmH_2O、腦脊液蛋白含量≥1.75 g/L時(shí)患者預(yù)后不良及死亡率明顯增加。
[Abstract]:Objective to investigate the clinical features and prognosis of 23 patients with Cryptococcus neoformans meningitis. Methods 23 patients with Cryptococcus neoformans meningitis diagnosed by etiology from March 2013 to December 2014 were selected. Results among 123 patients, 12 cases were subacute onset and 11 cases were chronic onset. The course of disease ranged from 9 days to 3 months. All of them had different degrees of fever, headache and meningeal irritation. All the patients showed negative HIV-Ab examination for 9 days to 3 months, the average course of disease was 45.7 鹵39.8 days, the time of diagnosis was 1 to 23 days, the average number of days was 7: 7.3 鹵5.7 days, the number of lumbar puncture was 1 to 9 times, the average number of times was 2.3 鹵1.7 times. 11 cases were misdiagnosed as tuberculous meningitis, 3 cases were misdiagnosed as viral encephalitis, and 323 cases were misdiagnosed as lupus encephalopathy. In 19 cases of Cryptococcus neoformans cultured in cerebrospinal fluid (CSF), meningeal enhancement appeared in 19 cases of Cryptococcus neoformans. Among 523 patients with hydrocephalus, ventricular dilatation and granuloma, 11 cases were cured, 7 cases were effective and 3 cases were ineffective. Two patients died of multiple organ failure. There were significant differences in age, duration of disease, first lumbar puncture pressure, basic disease, consciousness disorder and hydrocephalus between cured and uncured patients. Conclusion patients over 60 years old, more than 3 basic diseases, the course of disease 鈮，

本文編號(hào)：1777134