甘露醇用药时间对脑脊液中抗生素浓度的影响  

Effect of Time of Mannitol Administration on the Antibiotic Concentrations in Cerebrospinal Fluid

作　　者：厉春林[1] 郑慧军[1] 胡娜[1] 曾莹[1] 汪沁芳[1] 汪晖[1] 何跃[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院神经外科,湖北武汉430030

出　　处：《护理学杂志》2007年第8期1-2,共2页

基　　金：华中科技大学同济医学院附属同济医院2003年中青年科研基金资助项目(2003035)

摘　　要：目的探讨不同时间快速静脉输注甘露醇对脑脊液中抗生素浓度的影响,为临床合理安排甘露醇与抗生素的输注时间提供理论依据。方法选取神经外科术后患者12例,采用自身对照法于术后第1天开始,分别于5个时间段使用抗生素头孢三嗪,即应用抗生素后60min使用甘露醇(1组)、应用抗生素后30min使用甘露醇(2组)、同时应用甘露醇和抗生素(3组)、应用抗生素前30min使用甘露醇(4组)、应用抗生素前60min使用甘露醇(5组)。应用抗生素60min后留取脑脊液标本,采用反相离子对高效液相色谱法测定脑脊液中抗生素的浓度。结果应用抗生素后30min使用甘露醇,其脑脊液药物浓度显著高于其它时段(均P<0.01)。结论静脉输注抗生素后30min使用甘露醇,血脑屏障开放为最佳状态,抗生素通过率最大,有助于预防和治疗中枢神经系统感染。Objective The effect of time of mannitol administration on the antibiotic concentrations in Cerebrospinal fluid （CSF） was examined to provide data for rational use of the two drugs. Methods Twelve neurosurgical postoperative patients were studied on self-control basis. From the first day after operation, the mannitol was administered 1 h or 30 min after antibiotic（ceftriaxone） adminitration, or 30 min, 1 h before the antibiotic adminitration, or two drugs were used at the same time. The concentrations of the antibiotic in CSF was measured 1 h after administration of antibiotic by reversed-phase high performance liquid chromatography. Results The ceftriaxone concentration was highest when given 30 rain after the administration of antibiotic as compared with the concentrations of the antibiotic given at the other time points （P〈0. 01 for all）. Conclusion The blood-brain barrier （BBB） is open at the highest level 30 min after the infusion of antibiotic, and the ceftriaxone can pass through the BBB most easily, which is helpful for the prevention of CNS infection.

关 键 词：血脑屏障 脑脊液 甘露醇 用药时间 抗生素 头孢三嗪 药物浓度 

分 类 号：R473.6[医药卫生—护理学] R983.1[医药卫生—临床医学]