隐球菌性脑膜炎伴颅内高压患者行脑室-腹腔分流术的疗效。
Efficacy of ventriculoperitoneal shunting in patients with cryptococcal meningitis with intracranial hypertension.
机构信息
Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Digestive Medicine Institute, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.
出版信息
Int J Infect Dis. 2019 Nov;88:102-109. doi: 10.1016/j.ijid.2019.08.034. Epub 2019 Sep 6.
BACKGROUND
Ventriculoperitoneal (VP) shunting in cryptococcal meningitis (CM) patients with high intracranial pressure (ICP) has been studied extensively.
METHODS
A total of 74 CM patients with ICP were identified, including 27 patients with or without ventriculomegaly receiving VP shunting.
RESULTS
Through retrospective analysis, there was an obvious decline in ICP as well as Cryptococcus count after VP shunting. Damage to the cranial nerves was improved after the surgery. For those patients receiving VP shunting, there was an obvious decline in ICP as well as Cryptococcus count, with less usage of mannitol. Hydrocephalus or ventriculomegaly was improved, and both the clearance time of Cryptococcus and the hospitalization time were shortened (p<0.05). The complications of VP shunting were not common.
CONCLUSIONS
For patients diagnosed with CM and with apparent ICP, VP shunting can be considered regardless of whether there is damage to the cranial nerves or hydrocephaly.
背景
对于伴有颅内高压（ICP）的隐球菌性脑膜炎（CM）患者，脑室-腹腔（VP）分流术已得到广泛研究。
方法
共纳入 74 例伴有 ICP 的 CM 患者，其中 27 例伴有或不伴有脑室扩大的患者接受了 VP 分流术。
结果
通过回顾性分析，VP 分流术后 ICP 和隐球菌计数明显下降，颅神经损伤得到改善。对于接受 VP 分流术的患者，ICP 和隐球菌计数明显下降，甘露醇用量减少。脑积水或脑室扩大得到改善，隐球菌清除时间和住院时间均缩短（p<0.05）。VP 分流术的并发症并不常见。
结论
对于诊断为 CM 且 ICP 明显升高的患者，无论是否存在颅神经损伤或脑积水，均可考虑行 VP 分流术。
Zotero 插件