3例新型隐球菌脑膜炎的临床观察与护理

总结3例新型隐球菌脑膜炎的临床观察与护理,急性期早期加强颅内压的观察和护理,防止颅内压持续增高脑疝形成是治疗成功的关键。密切观察药物的毒副反应并及时处理,同时做好心理护理及基础护理。     

隐球菌性脑膜炎患者的临床观察及护理

目的 探讨隐球菌性脑膜炎患者的护理措施,以促进疾病的康复.方法 对12例隐球菌性脑膜炎患者在首选两性霉素B联合氟胞嘧啶应用、脱水剂降颅内压及纠正电解质紊乱等治疗的基础上,做好一系列护理措施(用药、相关检查、心理护理,饮食和生活指导及出院指导等).结果 12例患者治愈7例,好转3例,死亡2例,治愈好转率为83.3％.结论 及时到位的精心护理有利于隐球菌性脑膜炎患者的康复.     

新型隐球菌性脑膜炎的护理

新型隐球菌性脑膜炎虽不多见，但近年来发病率有所增加，由于此病病程长，病情重，药物治疗副作用大，使病人康复有一定的难度，本文地１２例新型隐球力性脑膜炎的护理进行了总结，着重报告了由此病引起民的严重症状颅内高压的护理，使用药物二性霉素Ｂ的观察要点，心理护理在长时间治疗过程中的重要作用。     

肺隐球菌病合并隐球菌性脑膜炎2例治疗与护理

肺隐球菌病合并隐球菌性脑膜炎在临床上十分少见 ,早期诊断较为困难 ,在发生中枢神经系统感染以前常漏诊或误诊为肺部肿瘤 ,错过治疗时机 ,最终导致中枢神经系统感染 ,使治疗难度增大。本文报道 2例肺隐球菌病合并隐球菌性脑膜炎的治疗与护理体会。1　临床资料例 1 ,男 ,2 3岁 ,学生。患者于 1 997年 7月在当地参加高考体检行胸片检查时发现右肺有一块状阴影 ,在外院行手术切除肿块 ,病变组织培养见“隐球菌” ,给予“大扶康 0 .3g每日 1次口服” ,治疗 1 5d出院。 6个月后患者自觉头痛 ,伴恶心、呕吐 ,腰穿查脑脊液见“隐球菌” ,诊断肺隐…     

一例隐球菌性脑膜炎患者的护理

隐球菌性脑膜炎是由于新型隐球菌所致的中枢神经系统感染性疾病,新型隐球菌广泛分布于自然界,主要生存于土壤和鸽粪中,为条件致病菌,易发生在全身免疫功能极度低下的患者。主要的临床症状为头痛、发热、头晕、呕吐、视力模糊或复视等[1]。我科于2012年2月收治1例新型隐球菌性脑膜炎患者,现将护理体会介绍如下。     

两性霉素B治疗新型隐球菌性脑膜炎的观察及护理

目的 观察静脉应用两性霉素B（AMB）治疗新型隐球菌性脑膜炎（隐脑）时发生的不良反应及护理疗效。方法 运用护理程序，对22例隐脑患者实施针对性护理，按护理疗效评估标准进行客观评价。结果 22例患者在应用AMB中有21例发生不良反应，但得到有效控制。结论 针对AMB在长程治疗中出现的各种不良反应，采取相应的护理措施，可防治和减轻不良反应的发生。     

艾滋病合并隐球菌性脑膜炎的观察和护理

总结了17例AIDS合并隐球菌性脑膜炎的临床护理绎验和体会。主要护理措施有关注患者的心理变化,及时给予心理疏导和健康宣教,严密观察病情,监测生命体征和特殊用药观察,加强症状护理及职业防护。认为通过严密观察病情,加强症状护理和职业防护,做好病人和家属的健康宣教和心理疏导,以及特殊用药的观察和护理,是护理AIDS合并隐球菌性脑膜炎的关键。     

55例新型隐球菌性脑膜炎的护理探讨

通过对55例新型隐球菌性脑膜炎患者采用两性霉素B、5—氟胞嘧啶(5—FC)等联合治疗的观察与护理,结果表明:作好患者的心理护理及保护性隔离,按要求备药以减轻药物副作用,供给营养丰富的饮食,对药物不良反应、脑室引流等方面实行积极有效的护理措施,能提高该病的治愈率,降低病死率;同时,还应加强对本疾病的健康教育、出院指导,以防止复发。     

2例新型隐球菌性脑膜炎的护理

目的探讨新型隐球菌性脑膜炎（CM）的发病特点，及时给予诊治护理，提高生命质量。方法在治疗新型隐球菌性脑膜炎患者的同时，针对药物副作用及病情变化，进行专门护理。结果2例患者通过有效的治疗及精心的护理，经复查各项检查指标均接近正常。自觉症状减轻，病情好转出院。结论本病对人类危害甚大，致残率、病死率较高。但是通过医护合作、综合护理，可降低新型隐球菌性脑膜炎患者的死亡率。     

隐球菌性脑膜炎合并肝硬化患者的护理

目的总结19例隐球菌性脑膜炎合并肝硬化患者的护理经验,以提高此类患者的临床护理水平。方法对我院2014年1月—2017年12月收治的19例隐球菌性脑膜炎合并肝硬化患者进行回顾性分析,包括一般患者资料、临床表现、治疗过程中病情观察及护理措施等。19例患者中Child-Pugh评分B级12例,C级7例,均为肝硬化失代偿。合并基础疾病患者9例,合并有肺隐球菌病7例。结果最终19例患者病情好转出院14例,维持现状4例,病情恶化自动出院1例。结论对有复杂合并症患者的治疗及护理需要重视病情观察,采取多学科会诊方式及有计划的护理措施,关注职业防护,防范药物使用中的不良反应,关心患者的心理活动,以促进患者康复。     

Cryptococcal meningitis in non-HIV-infected patients

There are few reports on cryptococcal meningitis in non-HIV-infected patients in subtropical areas. We reviewed 94 non-HIV-infected patients microbiologically diagnosed with cryptococcal meningitis and hospitalized at National Taiwan University Hospital, 1977-1996. Forty-two patients (44.7%) had underlying diseases. The main initial manifestations were headache (86.2%), vomiting (72.3%) and fever (69. 1%). The 30 patients with T-cell suppression had more acute illnesses (median duration of symptoms: 14 days vs. 29 days), less typical presentations of meningitis, and reduced inflammatory responses compared with the 64 without T cell suppression. There was no statistical difference between patients who received amphotericin B treatment for 10 weeks and those received amphotericin B with subsequent fluconazole treatment, in terms of mortality rate and recurrence rate. Seventy-five patients (79.8%) had satisfactory clinical responses, and two relapsed. Eighteen patients died (19.1%) and 10 of these died within 2 weeks of hospitalization. Patients in this series had outcomes comparable with those from temperate and even tropical countries with high percentages of immunocompetent hosts. Factors significantly associated with death were lymphoma, semicoma, leukocytosis, and initial high titres of cryptococcal antigen in cerebral spinal fluid (especially >/=1 : 512). On multivariate analysis, lymphoma and initial high cryptococcal antigen titres were independent predictors of mortality.     

系统性红斑狼疮合并隐球菌脑膜炎的诊断与治疗

目的:分析系统性红斑狼疮(SLE)合并中枢神经系统隐球菌感染的临床特点、诊断和治疗,以提高对本病的认识和诊治水平.方法:对3例SLE合并隐球菌脑膜炎(隐脑)病例的临床表现,脑脊液(CSF)变化及诊治经过进行回顾性分析.结果:SLE合并隐脑时的临床及实验室检查呈非特异性,易误诊成狼疮脑病或结核性脑膜炎(结脑),CSF涂片镜检或真菌培养发现隐球菌是确诊的关键.结论:早期诊断和有效抗真菌治疗有助于改善SLE合并隐脑患者的预后.     

Cryptococcal meningitis in an immunocompetent patient

Cryptococcal meningitis is a fungal infection that is most commonly thought of as an opportunistic infection affecting immunocompromised patients, classically patients with Human Immunodeficiency (HIV) infection. It is associated with a variety of complications including disseminated disease as well as neurologic complications including intracranial hypertension, cerebral infarcts, vision loss and other neurologic deficits. It is diagnosed by lumbar puncture with CSF studies, including fungal culture and cryptococcal antigen testing.We present a case of cryptococcal meningitis and fungemia in a previously healthy male patient who presented after multiple emergency department visits with persistent headache. After multiple visits, he underwent a lumbar puncture consistent with cryptococcal infection, and he was admitted to the hospital for initiation of antifungal therapy. His workup revealed no known underlying condition leading to immune compromise.     

糖尿病心肌病的临床观察与护理

目的:总结临床上糖尿病心肌病的护理经验。方法:对收治的39例糖尿病心肌病患者的观察及护理方法进行回顾性分析。结果:39例患者中有35例好转出院,2例猝死,2例死于严重心力衰竭。结论:准确的观察及护理能促进糖尿病心肌病患者康复,减少并发症发生,提高生活质量。     

窒息新生儿低血糖的临床观察及护理

新生儿窒息是当今围产儿死亡的主要原因。近年来由于儿科复苏技术的改进,窒息患儿的生存率有逐年上升的趋势。目前,关于如何防治窒息造成的各器官、系统的损伤,提高患儿的生活质量已引起了广大专家学者的注意[1]。由于在缺氧情况下,只能进行无氧酵解,因此消耗大量糖原,造成低血     

Cryptococcal meningitis in patients with AIDS.

In the U.S., cryptococcal meningitis is the most common form of fungal meningitis and a major cause of morbidity and mortality among immuno-suppressed patients. In the AIDS patient, cryptococcal meningitis often presents with fever and headache and is best treated with intravenous amphotericin B and oral flucytosine, or fluconazole. However, toxic effects may result from the therapy. This disease frequently relapses necessitating life-long treatment to prevent reactivation. Essential management principles focusing upon health education are presented to promote comprehensive nursing care for patients testing positive for the human immunodeficiency virus who also have cryptococcal meningitis.     

New guinea pig model of Cryptococcal meningitis

We developed a guinea pig model of cryptococcal meningitis to evaluate antifungal agents. Immunosuppressed animals challenged intracranially with Cryptococcus neoformans responded to fluconazole and voriconazole. Disease was monitored by serial cerebrospinal fluid (CSF) cultures and quantitative organ cultures. Our model produces disseminating central nervous system disease and responds to antifungal therapy.     

肠系膜血栓形成的观察与护理18例

肠系膜血栓形成是一种临床上少见的肠系膜血管阻塞性疾病,可引起肠系膜血管急性血循环障碍,一般起病比较隐匿,早期无特异的临床症状和体征,且发病急骤,可迅速发展成为腹膜炎和肠坏死。诊断困难,容易误诊,是导致该病高死亡率的原因。典型临床表现是间隙性、弥漫性腹痛、厌食等症     

隐球菌性脑膜炎并胼胝体变性1例

患者男，22岁，因不规则发热1个月，头痛2天入院。头痛剧烈，恶心、呕吐．出现发作性意忐丧失2次，自动清醒。1年前曾患带状疱疹，已治愈。10天前曾出现腹泻．大便呈蜂沫样，带少许白色黏液，3天后自动缓解。体检：患者消瘦，营养不良。神清、精神差。颅N（-），四肢肌张力正常，肌力Ⅴ级，腱反射活跃．病理症未引出，脑膜刺激症（＋）。     

Cryptococcal meningitis in a patient treated with infliximab

Infliximab, a tumor necrosis factor-alpha inhibitor, is increasingly used for the therapy of different inflammatory conditions. We report the first case of cryptococcal meningitis in a patient treated with infliximab and other immunosuppressive agents, and review a further 5 reported cryptococcal infections. All of them involved fungal pneumonia. Outcome was favorable in all cases.