Lumbar puncture drainage with intrathecal injection of amphotericin B for control of cryptococcal meningitis
Lumbar puncture drainage with intrathecal injection of amphotericin B for control of cryptococcal meningitis
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DOI：
10.1111/j.1439-0507.2009.01847.x
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发表时间：
2011-07-01
期刊：
影响因子：
4.9
通讯作者：
Gu Julin
中科院分区：
文献类型：
--
作者：
Chen Yuchong;Chen Jianghan;Gu Julin
隐球菌性脑膜炎是一种高死亡率的疾病，对两性霉素B和氟康唑等药物的静脉抗真菌治疗难以治愈。我们研究了腰穿刺导管引流与鞘内注射两性霉素B作为治疗隐球菌性脑膜炎。治疗组的14例患者在1年随访期间均无复发。并发症包括7例腰骶神经根刺激和7例尿潴留。这项研究表明，所使用的技术在控制症状方面是有效的。停止鞘内注射两性霉素B或低剂量治疗后，主要并发症消失。因此，这项技术可能是治疗隐球菌性脑膜炎的一种有效和安全的方法。
Cryptococcal meningitis is a disease with high mortality and refractory to intravenous antifungal treatments with agents such as amphotericin B and fluconazole. We investigated lumbar puncture catheter drainage with an intrathecal injection of amphotericin B as a treatment for cryptococcal meningitis. All of the 14 patients enrolled in the treatment group survived with no evidence of relapse during 1-year follow-up. Complications included lumbosacral nerve root irritation in seven patients and urinary retention in seven patients. This study demonstrated that the technique used was effective in controlling the symptoms. The major complications disappeared after discontinuation of intrathecal injection of amphotericin B or with low-dose therapy. Therefore, this technique could be an effective and safe method for the treatment of cryptococcal meningitis.