摘要
目的分析新型隐球菌脑膜炎的易感因素、临床特点、治疗及转归。方法回顾性分析2000年12月至2011年10月确诊的46例新型隐球菌脑膜炎。总结其临床表现、实验室检查、治疗及转归情况。结果46例患者均经脑脊液墨汁染色阳性确诊。22例（47．83％）合并有其他免疫系统疾病。治愈9例、好转18例、6例死亡、13例自动出院。结论患有免疫系统疾病是新型隐球菌脑膜炎的易感因素之一，在患有免疫系统疾病患者中出现发热、头痛等脑膜刺激征阳性，应及时行腰穿，反复行脑脊液墨汁涂片找隐球菌，及时明确诊断，联合鞘内注射两性霉素B能缩短脑脊液隐球菌转阴时间，以提高隐球菌脑膜炎临床疗效。
Objective To analyze the susceptible factors,clinical characteristics,treatments and prognosis of cryptococcal neoformans meningitis. Methods Forty-six patients with cryptococcal neoformans meningitis admitted to the first hospital affiliated to Soochow university from 2000 to 2011 were retrospectively analyzed.Clinical manifestations,data of laboratory examination,treatments and outcome were analyzed. Results All forty-six patients were diagnosed by cerebrospinal fluid ink staining positive.Twenty-two patients had immune system diseases,accounting for 47.83%.The outcome of 46 cases showed that 9 patients were cured,18 improved,6 patients died and 13 gave up any further treatment. Conclusion Suffering from the immune system disease is one of the susceptible factor of cryptococcus neoformans meningitis.People with immune system diseases have symptoms such as headache,fever or meningeal stimulation,should be timely treated with lumbar puncture and the cerebrospinal fluid must be examined repeatedly by ink staining to find Cryptococcus,in order to make sure that patients with cryptococcus meningitis be timely diagnosised.The method of combination with intrathecal injection of amphotericin B could shorten the interval between the occurrence of first symptoms and time point of cerebrospinal fluid ink staining negative and effectively improve the treatment of cryptococcus meningitis.
出处
《浙江临床医学》
2013年第3期306-309,共4页
Zhejiang Clinical Medical Journal
关键词
隐球菌
脑膜炎
诊断
鞘内注射
治疗
Cryptococcus
Meningitis
Diagnosis intrathecal injection
treatment
