耐多药结核性脑膜炎4例临床疗效分析并文献复习.pdfVIP

·500· ● 论著 ● 耐多药结核性脑膜炎4例临床疗效分析并文献复习 陈志成方毅敏 陈永浩董海平 (广州市胸科医院 广州 510095) 摘要：目的 探讨耐多药结核性脑膜炎的治疗方法、方案的组合、疗程并进行疗效判断。方法 回顾广州市胸科医院近年收治的4例脑脊液培养有耐多药抗酸杆菌生长的结核性脑膜炎患者状况， 进行临床疗效分析并文献复习。结果 经个体化的抗结核治疗方案，联合鞘内注射异烟肼等措施，其 中2例患者治愈停药。另2例患者因出现严重并发症或药物不良反应、救治无效而死亡。结论耐 多药结核性脑膜炎病情重、进展快、病死率高。目前，临床尚无统一的治疗方案。 关键词：结核，脑膜／药物疗法； 抗药性，多种，细菌； 治疗结果 通讯作者：陈志成(gzsxkyy@163．corn) On offourcases、订tIl tuberculous andliteraturesreview clinical meningitis Analysis efficacy multidrug-resistant Chert Yimin，Chen Zhicheng，Fang Yonghao，DongHaiping Chest 510095，China) (GuangzhouHospital，Guangzhou To theantituberculosis Abstract：0bjectiveinvestigate therapeutic and for tuberculous Fourtuberculous multidrug—resistantmeningitis．Methods efficacyjudgment caseswith tuberculosisisolatedfrom fluidwereana‘’ meningitis multidrug—-resistant cerebrospinal inour inrecent andrelevantliteratureswerereviewed．Results lyzedretrospectivelyhospital years weretreatedwithindividualanti--TB andcombinedwithintrathe‘_ Four therapeuticregimen patients cal withisoniazidanddexamethasone．Twohadbeencuredand withdrawal injection patients drug oradverse ConclusionTu— andtheothersweredeadduetoserious reaction． complicationsdrug tuberculosisareserious berculous caseswith disease，rapid meningitis multidrug—resistantusually