本文選題：腰大池引流 + 隱球菌�。� 參考：《廣東醫(yī)學(xué)》2015年23期

【摘要】：目的探討改良腰池引流配合持續(xù)鞘內(nèi)注射兩性霉素B(AMB)治療隱球菌腦膜炎效果。方法將30例隱球菌腦膜炎患者分為觀察組和對(duì)照組,每組15例。觀察組采用改良腰池引流技術(shù),持續(xù)引流腦脊液,并在全身抗真菌治療基礎(chǔ)輔予微量泵緩慢鞘內(nèi)注射AMB。對(duì)照組在全身抗真菌治療基礎(chǔ)上每周2~3次腰穿,每次腰穿放腦脊液5~10 m L,同時(shí)鞘內(nèi)注射AMB。結(jié)果兩組治療2周后癥狀體征療效觀察、腦脊液墨汁染色轉(zhuǎn)陰時(shí)間、使用AMB劑量、鞘內(nèi)給藥不良反應(yīng)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),觀察組優(yōu)于對(duì)照組而腦脊液細(xì)胞數(shù)、糖、氯、蛋白指標(biāo)變化、腦脊液隱球菌培養(yǎng)轉(zhuǎn)陰時(shí)間、并發(fā)感染差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論對(duì)于并發(fā)惡性顱高壓隱球菌腦膜炎患者采用改良腰池引流配合持續(xù)鞘內(nèi)注射AMB可提高隱球菌腦膜炎治療的有效率,加快病原清除和癥狀恢復(fù),縮短住院時(shí)間,同時(shí)顯著減少鞘內(nèi)注射引起癱瘓、肢體麻木、尿潴留等惡性不良事件。
[Abstract]:Objective to investigate the effect of modified lumbar cistern drainage combined with continuous intrathecal injection of amphotericin (AMB) in the treatment of Cryptococcus meningitis. Methods 30 patients with Cryptococcus meningitis were divided into observation group and control group with 15 cases in each group. In the observation group, modified lumbar cistern drainage technique was used to continuously drain cerebrospinal fluid (CSF), and AMB was injected slowly into the sheath of micropump on the basis of systemic antifungal therapy. In the control group, on the basis of systemic antifungal therapy, lumbar puncture was performed three times a week, and CSF was put into cerebrospinal fluid (CSF) 510m / L each time, and AMB was injected intrathecally. Results after 2 weeks of treatment, there were significant differences between the two groups in the effect of symptoms and signs, the time of negative staining of cerebrospinal fluid ink, the dosage of AMB and the adverse reaction of intrathecal administration. The observation group was superior to the control group in the number of cerebrospinal fluid cells, sugar and chlorine. There was no significant difference in the change of protein index, the time of negative culture of Cryptococcus in cerebrospinal fluid and the complication of infection (P 0.05). Conclusion the modified lumbar cistern drainage combined with continuous intrathecal injection of AMB in patients with cryptococcal meningitis complicated with malignant cranial hypertension can improve the effective rate of treatment of Cryptococcus meningococcal meningitis, accelerate the pathogen clearance and symptoms recovery, and shorten the hospital stay. At the same time, malignant adverse events such as paralysis, limb numbness and urinary retention were significantly reduced by intrathecal injection.
【作者單位】： 江西省胸科醫(yī)院神經(jīng)內(nèi)科;江西省黃慶仁藥店;江西省南昌市第七醫(yī)院內(nèi)科;
【基金】：江西省科技支撐計(jì)劃項(xiàng)目(編號(hào):20121BBG70046)
【分類號(hào)】：R519.4

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本文編號(hào)：1946262