结核性脑脓肿10例内科临床疗效分析

目的 探讨结核性脑脓肿有效的内科药物治疗方案组合、疗程以及疗效判断.方法 回顾广州市胸科医院近年收治的10例结核性脑脓肿患者,按初、复治方案原则抗结核药物治疗、配合鞘内注射异烟肼,并进行临床疗效分析.结果 初治6例复治4例患者经抗结核治疗后,影像学上表现为脑脓肿病灶周围水肿带消失、病灶完全吸收2例,基本吸收4例,明显吸收2例,有吸收1例,1例(因耐多药)吸收不明显.结论 对结核性脑脓肿应早期进行有效的抗结核内科治疗,常可使有潜在致命危险的患者成为可治愈的、并减少外科手术的可能.

Internai medical treatment for tuberculous brain abscesses in ten patients

Objective To explore an effective therapeutic scheme, courses of treatment, and efficacy judgment for tubercular brain abscesses. Methods The data on ten patients with tubercular brain abscesses who had been treated in our hospital in recent years were retrospectively analyzed. All the patients received antituberculotic drugs according to the initial treatment or retreatment schemes and also received intrathecal injections of isoniazid. The clinical efficacy was then analyzed. Results Ten patients included six with initial treatment and four with retreatment. After antituberculotic treatment, lesions of brain abscesses and edema around brain abscesses were disappeared completely in two patients, and lesions of brain abscesses were almost absorbed completely in four patients, and there were obvious absorption in two patients and slight absorption in one. But absorption was not obvious in one patient because of multidrug-resistant tuberculosis. Conclusions Effective antituberculotic treatment should be taken early in patient with tuberculous brain abscesses. It often can cure patients with potentially fatal danger and reduce the possibility of surgery.