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首页> 外文期刊>BMC Neurology >Ventriculoperitoneal shunts in non-HIV cryptococcal meningitis
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Ventriculoperitoneal shunts in non-HIV cryptococcal meningitis

机译：非HIV隐球菌性脑膜炎的心室腹膜分流

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Persistent and uncontrollable intracranial hypertension (ICH) and difficulty in reducing Cryptococcus count are severe problems in cryptococcal meningitis (CM) patients. The therapeutic effects of ventriculoperitoneal shunts (VPS) in non-HIV CM patients are not fully known, and the procedure is somewhat unusual. Here, our study offers a review to investigate the role of VPS in non-HIV CM. We retrospectively collected data on 23 non-HIV CM patients with and without ventriculomegaly from 2010 to 2016. Their demographic data, clinical manifestations, cerebrospinal fluid (CSF) features and outcomes were analysed. We found that non-HIV CM patients without ventriculomegaly were older, had earlier treatment times and had shorter symptom durations than CM patients with ventriculomegaly. In both groups, headache, vomiting, fever and loss of vision were the most common clinical features. CSF pressure and Cryptococcus count were significantly decreased after operation. VPS could provide sustained relief from ICH symptoms such as headache. 13% of patients had poor outcomes because of serious underlying disease, while 87% of patients had good outcomes. The use of a VPS is helpful in decreasing ICH and fungal overload in non-HIV CM patients, and VPS should be performed before CM patients present with symptoms of severe neurological deficit.
机译：在隐球菌性脑膜炎（CM）患者中，持续且不可控制的颅内高压（ICH）和降低隐球菌计数的困难是严重的问题。尚不完全了解非HIV CM患者的室腹膜分流术（VPS）的治疗效果，该程序有些不寻常。在这里，我们的研究提供了综述，以调查VPS在非HIV CM中的作用。我们回顾性收集了2010年至2016年23例有和没有心室肥大的非HIV CM患者的数据。分析了他们的人口统计学数据，临床表现，脑脊液（CSF）的特征和结局。我们发现，没有心室肥大的非HIV CM患者比有心室肥大的CM患者年龄更大，治疗时间更短，症状持续时间更短。在两组中，头痛，呕吐，发烧和视力丧失是最常见的临床特征。术后脑脊液压力和隐球菌计数明显降低。 VPS可以持续缓解ICH症状，例如头痛。由于严重的基础疾病，有13％的患者预后较差，而有87％的患者预后良好。 VPS的使用有助于减少非HIV CM患者的ICH和真菌超负荷，应在CM患者出现严重神经功能缺损症状之前进行VPS。

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