高压氧辅助治疗结核性脑膜炎及结核性脑膜脑炎疗效研究

Effects of adjuvant hyperbaric oxygen therapy on patients with tuberculous meningitis and tuberculous meningoencephalitis

目的探讨高压氧辅助抗结核药物治疗结核性脑膜炎和结核性脑膜脑炎(两者统称为结脑)的临床疗效,以建立结脑治疗的新方法。方法将我科2005年02月—2008年01月间确诊的64例结脑患者随机分为2组,对照组给予全身抗结核化疗+口服泼尼松治疗,治疗组在二者基础上给予高压氧辅助治疗。观察2组患者的体温、颅压、临床症状体征、颅内病灶吸收情况和脑脊液(CSF)等变化,并进行比较。结果治疗组患者体温、颅压降至正常,意识恢复时间及CSF中糖、蛋白质、氯化物等恢复时间均短于对照组(P<0.05);治疗1个月后,治疗组患者颅内病灶吸收情况及并发症改善优于对照组(P<0.05)。结论高压氧辅助全身抗结核药物治疗结脑疗效确切,有望缩短结脑的化疗疗程。

Objective To investigate the effects of adjuvant hyperbaric oxygen（HBO） therapy on patients with tuberculous meningitis and tuberculous meningoencephalitis, so as to establish a new method for the treatment of such patients. Methods From Feb. 2005 to Jan. 2008, a total of 64 patients with tuberculous meningitis and tuberculous meningoencephalitis were randomly divided into two groups. All patients were treated with antituberculous drugs and prednisone. In addition, the patients in the treatment group recieved HBO as an adjuvant therapy. The body temperature, intracranial pressure, clinical symptoms and signs, the absorption of the intracranial focus and the variation of cerebrospinal fluid （CSF） examination were observed and compared between the two groups. Results Body temperature, intracranial pressure, consciousness and CSF examination findings （protein, chloride, glucose concentration, etc.） returned to normal faster in the treatment group than in the control group （P〈0.05）. After one month of treatment, the improvement in the absorption of the intracranial focus and complication was superior to that in the control group（P〈0.05）. Conclusion The adjuvant HBO therapy can enhance the therapeutic effects of antituberculous drugs in the treatment of tuberculous meningitis and tuberculous meningoencephalitis, so that the chemotherapy courses for such patients can be shortened.