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目的 探讨影响隐球菌脑膜炎疗效的相关因素。方法 对1980～1995年间诊治的11例隐球菌脑膜炎病例进行回顾性分析。结果 在疗效成功的7例中,联合应用二性霉素B和氟胞嘧啶的效果肯定;其中5例在疗程中进行了侧脑室外引流术,另有1例在疗程初期还联合应用了氟康唑,均获明显临床效果。11例中,4例在抗真菌治疗中死亡,影响其疗效及预后的相关因素主要为:病情进展较快(2/11例)、诊治时间偏迟、宿主免疫功能低下、可累及中枢神经系统的基础疾病及持续性脑脊液显著异常。结论 隐球菌脑膜炎早期诊断困难,抗真菌联合疗法和适时的脑脊液引流是有效的治疗措施。
Objective To investigate the factors affecting the efficacy of cryptococcal meningitis. Methods 11 cases of cryptococcal meningitis diagnosed and treated between 1980 and 1995 were retrospectively analyzed. Results Among the 7 cases with successful curative effect, the combination of amphotericin B and flucytosine was affirmed. Among them, 5 cases were treated with lateral ventricle drainage during the course of treatment, and the other one was treated with fluorine Conazole, were significantly clinical results. Among the 11 cases, 4 cases died of antifungal therapy. The main factors influencing the curative effect and prognosis were as follows: the disease progressed rapidly (2/11 cases), the diagnosis and treatment time was delayed, the host immune function was low, and the central nervous system The underlying disease and persistent abnormal cerebrospinal fluid. Conclusion Cryptococcal meningitis is difficult to diagnose early, anti-fungal combination therapy and timely drainage of cerebrospinal fluid is an effective treatment.