目的 觀察復(fù)方甘草酸苷片聯(lián)合復(fù)方氟米松軟膏治療播散性神經(jīng)性皮炎的療效。 方法 2008年6月-2009年6月對(duì)播散性神經(jīng)性皮炎100例隨機(jī)分為治療組與對(duì)照組，治療組給予復(fù)方甘草酸苷片和復(fù)方氟米松軟膏；對(duì)照組給予復(fù)方地塞米松軟膏。兩組均同時(shí)使用常規(guī)抗組胺藥，治療2 周后比較療效。 結(jié)果 治療組總有效率(91.2%)明顯高于對(duì)照組(76.7%)。治療組用藥第2 天即起效，未發(fā)現(xiàn)明顯不良反應(yīng)。 結(jié)論 復(fù)方甘草酸苷片聯(lián)合復(fù)方氟米松軟膏治療播散性神經(jīng)性皮炎迅速、安全、有效、費(fèi)用低，值得推廣。
【摘要】 目的 分析急性播散性腦脊髓炎的臨床特點(diǎn)，提高診療。 方法 收集1999年1月-2010年1月住院的急性播散性腦脊髓炎患者42例，對(duì)其臨床癥狀體征、實(shí)驗(yàn)室檢查、影像學(xué)改變及治療進(jìn)行全面回顧性分析。 結(jié)果 42例患者中5～14歲者11例（26.19%）；15～40歲者20例（47.62%），感染后引起的23例（54.76%），無(wú)明顯誘因占15例（35.71%）；腦脊液23例（23/34，67.65%）異常；腦電圖異常者27例（27/32，84.38%）；CT檢查陽(yáng)性率26例（26/40，65.00%），MRI陽(yáng)性率25例（25/28，89.29%）；糖皮質(zhì)素、丙種球蛋白治療有效。 結(jié)論 急性播散性腦脊髓炎是一組臨床表現(xiàn)多樣的免疫介導(dǎo)的炎性疾病，腦脊液、MRI和腦電圖有重要診斷價(jià)值。急性期大劑量皮質(zhì)素、靜脈丙種球蛋白治療均有較好療效?！続bstract】 Objective To analysis the clinical features of acute disseminated encephalomyelitis so as to improve medical treatment. Methods From January, 1999 to January, 2010, 42 inpatients with acute disseminated encephalomyelitis were collected and their clinical data were analyzed retrospectively. Results Out of these 42 patients, 11 (26.19% ) were within 5 to 14 years, 20 (47.62%) ithin 15 to 40 years; 23 (54.76%) had definite infection, and 15 (35. 71%)had no any causes; 23 (23/34, 67.65%) had abnormal cerebrospinal fluid; 27 (27/32, 84.38%) had abnormal electro-encephalograph; 26 (26/40, 65.00%) were CT positive, 25 (25/28, 89.29%) MRI positive; corticosteroids and gamma globulin were effective in the treatment of disseminated encephalomyelitis. Conclusion Acute disseminated encephalomyelitis is a kind of inflammatory disease with various clinical manifestation and mediated by immune. Cerebrospinal fluid, MRI, and electro-encephalograph have important roles in its diagnosis. Large dose of corticosteroids and gamma globulin are effective in the treatment of acute disseminated encephalomyelitis.
目的 總結(jié)播散性馬爾尼菲青霉菌病的特征, 以提高臨床醫(yī)生對(duì)播散性馬爾尼菲青霉菌病的認(rèn)識(shí)。方法 通過(guò)對(duì)1 例非免疫受損者播散性馬爾尼菲青霉菌病例的臨床、影像學(xué)及細(xì)菌學(xué)分析, 并復(fù)習(xí)播散性馬爾尼菲青霉菌病的相關(guān)文獻(xiàn), 從而總結(jié)其特征。結(jié)果 患者男性, 32 歲, 廣東人, 以發(fā)熱、咳嗽及肺部、氣道黏膜、皮下等多系統(tǒng)結(jié)節(jié)病變或膿性包塊為主要臨床表現(xiàn); 實(shí)驗(yàn)室檢查顯示血常規(guī)白細(xì)胞明顯升高, 心、肝、腎多臟器損害; 曾多次包塊活檢顯示炎癥表現(xiàn), 但膿腫分泌物培養(yǎng)陰性; 廣譜抗生素治療無(wú)效。纖維支氣管鏡下見(jiàn)氣道黏膜灰白色結(jié)節(jié), 最后在細(xì)菌學(xué)專家床邊指導(dǎo)下皮下腫塊膿性分泌物真菌培養(yǎng)及纖維支氣管鏡深部痰真菌培養(yǎng)確診馬爾尼菲青霉菌病。結(jié)論 播散性馬爾尼菲青霉菌病可發(fā)生于免疫功能正?；颊? 對(duì)于用結(jié)締組織病及普通化膿性感染等無(wú)法解釋的多系統(tǒng)損害、多發(fā)化膿性皮下包塊, 又有南方流行區(qū)生活史的患者, 應(yīng)警惕馬爾尼菲青霉菌感染, 并盡早確診和治療。