脑室内注射抗生素治疗高血压脑出血术后颅内感染的临床研究  

Clinical study on intraventricular injection of antibiotics for intracranial infection following cranial surgery for hypertensive cerebral hemorrhage

作　　者：张帅[1] 张守庆[1] 

机构地区：[1]山东莱芜市人民医院神经外科,莱芜271100

出　　处：《中国实用神经疾病杂志》2014年第8期26-28,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的研究脑室内注射抗生素治疗高血压脑出血术后颅内感染的临床疗效,以期为临床治疗提供一定的参考意见。方法选取2011-01—2013-01入院诊治的高血压脑出血行开颅手术后颅内感染的患者80例,均行脑室内注射抗生素以治疗感染,观察患者的治疗效果,并对比患者治疗前后的格拉斯哥评分及生活质量情况。结果 80例患者中治愈70例,治愈率87.50%;死亡5例,病死率6.25%;平均住院时间(31.2±7.4)d。治疗前轻度昏迷0例,中度昏迷12例,重度昏迷32例,低于3分的重度昏迷36例;治疗后轻度昏迷17例,中度昏迷23例,重度昏迷21例,低于3分的重度昏迷下降到19例;治疗前后差异显著(P<0.05)。与治疗前相比,患者在总体健康、积极感受、日常生活能力方面均有显著提高,并且在疼痛与不适、对药物及医疗手段的依赖性方面显著下降;治疗前后差异显著(P<0.05)。结论脑室内注射抗生素可有效治疗高血压脑出血术后颅内感染,并提高患者的生活质量、降低昏迷程度;围手术期应加强颅内感染的预防,同时加强对颅内感染患者的相关护理工作。Objective To study the clinical efficacy of intraventricular administration of antibiotics for intracranial infection secondary to cranial surgery for hypertensive cerebral hemorrhage ,and to provide reference for clinical treatment.Methods Eighty patients with intracranial infection following cranial surgery for hypertensive cerebral hemorrhage from January 2011-January 2013 admitted to our hospital were performed intraventricular administration of antibiotics to treat the infection ,the ef-ficacy was observed ,Hougesila scores of patients before and after treatment and quality of their life were compared. Results Seventy cases of the 80 patients were cured ,the cure rate was 87.50% ;5 deaths ,mortality rate 6.25% ;the mean hospital stay was 31.2 ± 7.4 days. Before treatment ,mild coma 0 cases ,moderate coma 12 cases ,32 cases of severe coma ,Patients with severe coma less than 3 scores were up to 36 cases ;after treatment ,patients with mild coma was 17 cases ,moderate coma 23 cases ,21 cases of severe coma ,Patients with severe coma less than 3 scores dropped to 19 cases;the difference before and after treatment was significant （P〈0.05）.Compared with those before treatment ,patients in the general health ,positive feel-ings ,capacity of daily living had been significantly improved ;the pain and discomfort ,the dependence on drug and medical in-struments all decreased significantly ;the difference before and after treatment was significant （P〈 0.05）.Conclusion intra-ventricular injection of antibiotics is effective in the treatment of intracranial infections secondary to surgery for hypertensive cerebral hemorrhage and can improve patients’ quality of life ,reduce the degree of coma ;the prevention from perioperative in-tracranial infection should be strengthened ,while strengthening care for patients with intracranial infection should be per-formed.

关 键 词：脑室内注射抗生素 高血压脑出血 开颅手术 颅内感染 治疗 

分 类 号：R743.34[医药卫生—神经病学与精神病学]