脑脊液置换加静脉及鞘内注射两性霉素B治疗新型隐球菌性脑膜炎疗效研究

Research on the curative effect of cerebrospinal fluid replacement combining intravenous drips and intrathecal injection of amphotericin B in the treatment of cryptococcal neoformans meningitis

目的研究脑脊液置换加静滴及鞘内注射两性毒素 B 治疗新型隐球菌性脑膜炎(简称隐脑)的疗效。方法将收治的28例隐脑患者随机分为两组。A 组脑脊液置换加静滴及鞘内注射两性霉素 B 为治疗组。B 组仅静滴及鞘内注射两性霉素 B 为对照组,治疗共16周。以症状、体征、CSF 常规、CSF 培养及涂片为评定疗效。结果治疗组比对照组疗效佳,两者比较差异有统计学意义(P<0.05)。结论治疗组疗效佳,在基层医院不失为一种治疗新型隐球菌性脑膜炎的最佳方法之一,值得进一步研究。而两性霉素 B 仍为治疗隐脑最基本,最廉价和最重要的药物之一。

Objective To study the curative effect of cerebrospinal fluid replacement combining intravenous drips and intrathecal injection of amphotericin B in the treatment of cryptococcal neoformans meningitis（CNM for short）. Methods 28 CNM patients were randomly divided into two groups. Group A was the treatment group,and the treatment method was cerebrospina[ fluid replacement combining intravenous drips and intrathecal injection of amphotericin B. Group B was the control group,and the treatment method was only intravenous drips and intrathecal injection of amphotericin B. The period of treatment was 16 weeks. The curative effect was assessed in terms of symptoms, physical features, CSF routine examination, C, SF cultivation and smear examination. Results The curative effect of treatment group was better than that of the control group, There were remarkable differences between these two groups（ P 〈 0.05）. Conclusion The curative effect of treatment group is relatively good,and this treatraent method indeed is one of the best methods in the treatment of cryptococcal neoformans meningitis in grassroots hosphals. It is worthy of further research, and amphotericin B is still one of the most basic, cheapest and most important medicines in the treatment of CNM.