新型隐球菌脑膜炎18例临床治疗分析及文献复习

A clinical study of 18 cases of cryptococcal meningitis with a literature review

目的探讨新型隐球菌脑膜炎(CNM)的治疗及转归。方法对18例CNM患者的临床资料进行回顾性分析并文献复习。结果18例患者均经病原学确诊。单用氟康唑治疗6例,随访观察治愈、好转者3例,死亡3例;两性霉素B(Am B)和氟康唑(FCZ)序贯治疗12例,随访观察治愈、好转者10例,死亡2例。结论联合用药抗真菌效果较好,脑室引流能较快缓解症状、改善预后。

Objective To explore the clinical characters and diagnosis-treatment measures of eryptoeoeeus neoformans meningitis（CNM）. Methods We retrospectively analyzed the clinical data of 18 patients with eryptoeoeeal meningitis. The revelant medical literature was reviewed. Results All patients were identified by pathogen. Three of 6 patients were successfully cured with fuleonazole. Ten of 12 patients totally recovered with amphoteriein B and fuleonazole sequential therapy. Paraventrieulostomy was performed in 5 patients with enlarged ventricle. Conclusion Combination of antifungal therapy could achieve better effect. Ventrieulostomy could release symptoms and ameliorate prognosis.