中枢神经系统新型隐球菌感染19例临床分析

目的总结新型隐球菌性脑膜炎(CM)的临床表现,实验检查,影像学表现和治疗预后,以探讨CM的治疗方法和进展。方法采用回顾性方法分析19例经临床确诊的CM临床资料并进行总结和统计分析。结果总死亡率为36.8%,全为腰穿压力大于400毫米汞柱患者,腰穿压力>400mmH2O及脑积水患者行侧脑室引流并脑室内注药脑疝发生率降低。结论保守治疗首选氟康唑,联合应用两性霉素B鞘内注射;颅内压>400mmH2O或有脑积水患者应及早行侧脑室引流。

Clinical Analysis of 19 Cases of Cryptococcus Meningitis

Objective To search the clinical manifestations, data of laboratory features of CT, therapy, prognosis in order to evaluate the progress in therapy of patients with Cryptococcus meningitis(CM). Methods The findings of clinical features were analyzed and summarized for therapy of 19 CM cases. Results The total mortality was 36.8%. The mortality of patients whose intracranial pressure were more than 400 mmHg reduced if treating with drainage of lateral ventricle. Conclusions It is indicated that fluconazole is the first choice to the patients of CM in combination with the intrathecal injection of amphotericin B. Drainage of lateral ventricle by the first is useful for the patients whose intracranial pressure is more than 400 mmHg or with hydrocephalus.