鞘内灌洗治疗颅脑术后颅内感染31例临床分析  

Comparison of different intrathecal cure for intracranial infections after craniotomy

作　　者：张伟[1] 袁永刚[1] 钟波[1] 孙高令[1] 袁训辉[1] 王法臣[1] 白云安[1] 

机构地区：[1]潍坊医学院附属益都中心医院神经外科,青州262500

出　　处：《中国实用神经疾病杂志》2012年第9期13-15,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨不同方法鞘内用药治疗颅脑术后颅内感染的临床疗效。方法利用腰大池置管鞘内抗生素液不等量灌洗及腰穿脑脊液等量置换鞘内注药法治疗神经外科术后颅内感染患者31例,比较2组体温、脑脊液白细胞变化及脑脊液蛋白含量变化。结果不等量灌洗组治愈13例,死亡1例;体温3d内降至正常者8例(57.1%),2周内降至正常者13例(92.9%)。腰穿组17例均治愈;体温3d内降至正常者3例(17.6%),2周内降至正常者10例(58.8%)。2组比较差异具有统计学意义(P<0.05)。不等量灌洗组脑脊液中白细胞计数和蛋白含量在治疗后3d内下降率明显高于腰穿组者(P<0.05)。结论腰大池置管鞘内抗生素液不等量灌洗能快速降低颅脑术后颅内感染患者体温及脑脊液中白细胞和蛋白含量,缩短其住院时间,具有良好疗效,但应尽早、及时、足程应用。Objective To investigate the therapy of intracranial infection associated with neurosurgical operations.Methods A retrospective study of 31 patients,who got intracranial infection after neurosurgical operations between Sep.2005 and Aug.2011 in our hospital,was made.Intrathecal disparate irrigation was used in 14 cases,while 17 cases used lumbar puncture replacement.Results Temperature of 8 cases of irrigation group went normal during 3 days and 13 in 2 weeks,the number of lumbar puncture group was 3 and 10,respectively.White cells and protein in cerebralspinal fluid went down clearly in 3 days after disparate irrigation,which was better than lumbar puncture clearly（P0.05）.No adverse reactions were found.Conclusion Intrathecal disparate irrigation could degrade the temperature,white cells and proteins in the cerebrospinal fluid of the patients suffering intracranial infection after craniotomy more faster,and decurtate the length of stay.But it should be performed earlier,promptly and with enough course.

关 键 词：颅脑手术 颅内感染 鞘内灌洗 腰穿置换 

分 类 号：R651.11[医药卫生—外科学]