摘要
目的探讨经神经外科手术治疗的获得性免疫缺陷综合征(AIDS)合并中枢神经系统感染者的临床特点。方法回顾性分析2012年1月至2018年12月于首都医科大学附属北京地坛医院神经外科行手术治疗的62例AIDS合并中枢神经系统感染者的临床资料。结果经手术治疗的62例AIDS合并中枢神经系统感染者占神经外科同期收治的AIDS合并中枢神经系统病变患者的28.4%(62/218),主要临床表现为发热、颅内高压、功能障碍、头晕以及癫痫。32例(51.6%)患者接受分流术,11例(17.7%)患者行病变活检术,19例(30.6%)患者开颅行颅内占位切除术。经实验室检测及术后病理确诊的62例患者中真菌感染33例(53.2%),病毒及梅毒肉芽肿感染各1例(1.6%),寄生虫感染5例(8.1%),结核分枝杆菌感染8例(12.9%),细菌感染4例(6.5%),不明原因感染9例(14.5%),混合性感染1例(1.6%)。经手术治疗后,46例(74.2%)患者好转,14例(22.6%)患者无变化,2例(3.2%)患者放弃治疗。结论AIDS合并中枢神经系统感染病原谱广泛,临床表现以发热、颅内高压、功能障碍、头晕、癫痫为主,真菌感染发病率最高,手术干预为此类疾病诊疗的重要手段之一,可提高其诊疗效率。
Objective To investigate the clinical characteristics of cases with acquired immunodeficiency syndrome(AIDS)complicated with central nervous system(CNS)treated by neurosurgery.Methods From January 2012 to December 2018,the clinical data of 62 patients with AIDS and CNS infection were analyzed,retrospectively.Results The 62 cases with AIDS and CNS infection who received surgical treatment accounted for 28.4%(62/218)of the AIDS cases with CNS lesions in the Department of Neurosurgery during the same period.The main clinical manifestations were fever,intracranial hypertension,dysfunction,dizziness and epilepsy.There were 32(51.6%)cases underwent shunt,11(17.7%)cases underwent pathological biopsy and 19(30.6%)cases underwent intracranial space-occupying resection.Among the 62 cases diagnosed by laboratory and postoperative pathology,33(53.2%)cases with fungal infection,1(1.6%)case with virus infection,1 case(1.6%)with syphilis granuloma infection,5(8.1%)cases with parasitic infection,8(12.9%)cases with Mycobacterium tuberculosis infection,4(6.5%)cases with bacterial infection,9(14.5%)cases with unexplained infections,1(1.6%)case with mixed infection.After surgical treatment,46(74.2%)cases improved,14(22.6%)cases had no improvement,and 2(3.2%)cases gave up treatment.Conclusions The spectrum of pathogenic of AIDS complicated with CNS infection was extensive,the clinical manifestations were fever,intracranial hypertension,dysfunction,dizziness and epilepsy;the incidence of fungal infection was the highest.Surgical intervention could be used as an important mean of diagnosis and treatment of this kind of disease,and the efficiency of diagnosis and treatment could be improved.
作者
陈凤欣
梁庭毓
赵红心
冯恩山
Chen Fengxin;Liang Tingyu;Zhao Hongxin;Feng Enshan(Department of Infectious Diseases,National Clinical Key Specialty for Infectious Diseases;Department of Neurosurgery,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2020年第4期345-347,共3页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
基金
“十三五”国家科技重大专项基金资助项目(No.2018ZX10715-005)。
关键词
获得性免疫缺陷综合征
中枢神经系统
机会性感染
手术
Acquired immunodeficiency syndrome
Central nervous system
Opportunistic infection
Surgical treatment
