根治性手术在中枢神经系统结核合并HIV感染治疗中的应用

C. Petrov, О. N. Novitskaya
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引用次数: 0

摘要

客观的根据自己的材料,确定根治性手术方法在治疗HIV感染患者大脑结核形成中的作用。材料和方法。研究:2008年至2020年IOKB SSPB的统计形式,2017年至2020年间的FTBPR数据,56例患者的疾病性质,8例患者的长期疾病动力学,331例死者的尸检材料和9例中枢神经系统损伤(CNS)患者的活检。结果和讨论。结核性脑膜脑炎患者的数量在住院设施的结构中增加,其中病死率也在增长。幸存者需要神经外科护理的比例为25%。对手术治疗患者的长期监测显示,他们的生存率更高,手术的临床效果显著,寿命延长,CD4淋巴细胞在术后3、5年内增加了2.7倍。当在低免疫状态下服用ART时,注意到中枢神经系统结核病变周围形成限制性过程。结论彻底清除HIV患者中枢神经系统结核形成是合理的。
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Place of radical surgery in tuberculosis treatment of central nervous system in combination with HIV infection
Objective. On the basis of own material determine the role of radical surgery methods in treating tubercular formations of the brain in HIV-infected patients.Materials and Methods. Studied: statistical forms of the SSPB of the IOKB from 2008 to 2020, FTBPR data from 2017 to 2020, nature of the disease in 56, long-term disease dynamics — in 8, the autopsy material of 331 dead and the biopsy — 9 patients operated on with central nervous system damage (CNS).Results and Discussion. The number of patients with tuberculous meningoencephalitis increases in the structure of in-patient facilities, case-fatality rate among them grows. Need for neurosurgical care among the survivors is 25%. Long-term monitoring of operatively treated patients shows their higher survival rate, significant clinical effect of surgery, lengthening of life, increase of CD4 lymphocytes by 2,7 times in 3,5 years after the surgery. Formation of restrictive processes around tuberculous lesion in CNS was noted when taking ART with low immune status.Conclusion. Radical removal of tubercular formations of CNS in HIV is reasonable.
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来源期刊
HIV Infection and Immunosuppressive Disorders
HIV Infection and Immunosuppressive Disorders Medicine-Infectious Diseases
CiteScore
0.70
自引率
0.00%
发文量
37
期刊介绍: In the scientific-practical journal "HIV Infection and Immunosuppressive Disorders", published various issues of HIV medicine (epidemiology, molecular mechanisms of pathogenesis to the development of educational programs) leading scientists of Russia and countries of CIS, USA, as well as practical healthcare professionals working in research centers, research institutes, universities, clinics where done basic medical work. A special place on the pages of the publication is given to basic and clinical research, analytical reviews of contemporary and foreign reports, the provision of medical care for various diseases.
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