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鼻脑型毛霉菌病:一种有效治疗方案的前瞻性分析

Rhinocerebral Mucormycosis: A Prospective Analysis of an Effective Treatment Protocol.

作者信息

Ramadorai Ashok, Ravi Poornima, Narayanan Vinod

机构信息

Department of Oral and Maxillofacial Surgery, Saveetha Dental College, Chennai, Tamil Nadu, India.

Department of Oral and Maxillofacial Surgery, SRM Dental College, Chennai, Tamil Nadu, India.

出版信息

Ann Maxillofac Surg. 2019 Jan-Jun;9(1):192-196. doi: 10.4103/ams.ams_231_18.

Abstract

OBJECTIVE

The objective of this study was to prospectively analyze the effectiveness of a treatment protocol in patients diagnosed with rhinocerebral mucormycosis.

MATERIALS AND METHODS

This series included ten patients who reported with suspicious clinical signs of mucormycosis. The diagnosis was established by histopathology, and computed tomography imaging was used to assess the extent of spread. All patients were treated with immediate radical surgical debridement and antifungal chemotherapy with amphotericin B. Simultaneous correction of the underlying immunosuppressive condition was carried out. The primary outcome assessed was disease-free survival, and the patients were followed up for up to 6 months after discharge.

RESULTS

In this series, the cause of immunosuppression was uncontrolled diabetes mellitus in all patients. All the patients responded to the treatment protocol and were free of the disease up to 6 months of follow-up.

CONCLUSION

Mucormycosis is an invasive and potentially fatal disease. Prognosis can be improved by early recognition and prompt treatment with aggressive resection, intravenous amphotericin B, and control of the patient's underlying systemic condition.

摘要

目的

本研究的目的是前瞻性分析一种治疗方案对诊断为鼻脑型毛霉菌病患者的有效性。

材料与方法

该系列包括10例有毛霉菌病可疑临床体征的患者。通过组织病理学确诊,并使用计算机断层扫描成像评估病变扩散程度。所有患者均接受了立即根治性手术清创和两性霉素B抗真菌化疗。同时对潜在的免疫抑制状况进行了纠正。评估的主要结局是无病生存期,患者出院后随访长达6个月。

结果

在该系列中,所有患者免疫抑制的原因均为未控制的糖尿病。所有患者对治疗方案均有反应,随访6个月时均无疾病。

结论

毛霉菌病是一种侵袭性且可能致命的疾病。通过早期识别并及时采用积极切除、静脉注射两性霉素B以及控制患者潜在的全身状况进行治疗,可改善预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3761/6585200/1e9c08d6108c/AMS-9-192-g001.jpg

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