长程脑室外引流治疗艾滋病合并新型隐球菌脑膜炎颅高压初探

Preliminary Study of Long-Term Extraventricular Drainage in the Treatment of AIDS Patients with Cryptococcal Meningitis and Intracranial Hypertension

摘要:

目的：探讨长程脑室外引流术在艾滋病(AIDS)合并新型隐球菌性脑膜炎(CM)颅高压患者中的临床疗效及安全性。方法：选取2022年11月至2024年11月于我院接受治疗的40例AIDS合并CM颅高压患者为研究对象,按照随机数表法分为观察组(长程脑室外引流术)和对照组(传统脑室外引流术),各20例。所有患者均接受标准抗真菌治疗,并进行相应的颅内压监测管理。比较两组患者的临床疗效和并发症发生情况(感染、出血、引流管渗液)。结果：观察组的总有效率(95.00%)高于对照组(80.00%),但差异无统计学意义(P>0.05)；观察组的并发症发生率显著低于对照组(5.00% vs. 30.00%, P=0.037),其中感染、出血及引流管渗液的发生率均低于对照组。结论：长程脑室外引流术在AIDS合并CM颅高压患者中的应用具有较好的安全性,可有效降低术后并发症发生率,并能减少手术次数,维持颅内压正常稳定,值得临床应用推广。

Abstract:

Objective To investigate the clinical efficacy and safety of long-term extraventricular drainage in AIDS patients with cryptococcal meningitis (CM) and intracranial hypertension. Methods From November 2022 to November 2024, 40 AIDS patients with CM and intracranial hypertension who were treated in our hospital were selected as the research subjects. They were randomly divided into the observation group (long-term extraventricular drainage) and the control group (traditional extraventricular drainage), with 20 cases in each group. All patients received standard antifungal treatment and corresponding intracranial pressure monitoring management. The clinical efficacy and complications (infection, bleeding, drainage tube leakage) of the two groups were compared. Results The total effective rate of the observation group (95.00%) was higher than that of the control group (80.00%), but the difference was not statistically significant (P>0.05); the incidence of complications in the observation group was significantly lower than that in the control group (5.00% vs. 30.00%, P=0.037), with infection, bleeding, and drainage tube leakage rates all lower than those in the control group. Conclusion The application of long-term extraventricular drainage in AIDS patients with CM and intracranial hypertension has good safety, can effectively reduce the incidence of postoperative complications, and can reduce the number of surgeries, maintaining normal and stable intracranial pressure, which is worth promoting in clinical application.