静脉联合鞘内应用两性霉素B治疗隐球菌性脑膜炎23例的不良反应及疗效观察

目的探讨静脉联合鞘内应用两性霉素B(AmB)治疗隐球菌性脑膜炎(隐脑)的疗效及发生的不良反应。方法回顾性分析应用AmB治疗23例隐脑疗效及各种不良反应,以及不良反应的防治措施。结果23例患者静脉联合鞘内应用AmB治愈率78.3%,治疗过程中有20例发生各种不良反应,包括即刻反应、血细胞异常减少、肝肾功能损害、心脏毒性、低钾血症及静脉炎。其中以肾、肝功能损害及低钾血症最为多见,其发生比率分别为43.6%、40.0%、38.2%。结论静脉早期联合鞘内应用AmB治疗隐脑疗效明显,在长程治疗中会出现各种不良反应,应密切观察病情变化,定期随访,及时防治不良反应的发生。

To study the effect and untoward reaction with Amphotericin B to cryptococcal meningitis through intratheca and veins

Objective To study the effect and untoward reaction with Amphotericin B to cryptococcal meningitis through intratheca and veins.Methods 23 cases of cryptococcal meningitis are treated with Amphotericin B and analyse the untoward reactions and controlling ways. Results The recovering rate is 78.3% with untoward reactions in 20 cases,including immediate reaction,reducing of blood cells,decreasing of liver and kidney functions,toxicity to heart,kaliopenia,and phlebitis.Its rate is 43.6%,40.0%,38.2% in decreasing of liver and kidney functions,kaliopenia.Conclusion There is significant effect and untoward reaction in cryptococcal meningitis cases with Amphotericin B through veins and intratheca.Untoward reactions are controlled timely through observing the changes of disease and visiting on time.