开颅手术患者术后常规腰穿防治颅内感染的作用  

Effect of conventional lumbar puncture on the prevention and treatment of intracranial infection after craniotomy

作　　者：高风全[1] 张极星[1] 陈大刚[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院神经外科,黑龙江齐齐哈尔161002

出　　处：《中华医院感染学杂志》2015年第7期1616-1617,1625,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省科技厅研究基金资助项目(黑科成登字:2010-0827-01)

摘　　要：目的研究常规腰穿对开颅手术后颅内感染患者的防治作用,指导临床防治开颅手术患者颅内感染的防治。方法选取符合开颅手术颅内感染诊断标准的患者44例,采用常规抗菌药物治疗的患者18例为对照组;在常规治疗的基础上每天行常规腰穿鞘内注射抗菌药物的26例患者为腰穿组,对比两组患者临床指标,采用Excel进行分析。结果腰穿组患者颅内感染治愈25例治愈率为96.15%,对照组患者治愈16例治愈率为88.89%,腰穿组患者的治愈率稍高于对照组患者,但差异无统计学意义;腰穿组和对照组患者在治疗后体温、脑脊液蛋白含量、葡萄糖含量及脑脊液中白细胞个数与治疗前相比,差异均有统计学意义(P<0.05);腰穿组26例患者,部分患者在感染治愈后有腰痛症状,但均能耐受;对照组患者无此症状发生。结论常规腰穿对于防治开颅手术后颅内感染的治愈率高、疗效好、临床有效治疗时间短,不良反应能够耐受,因此应作为临床常用的控制和治疗开颅手术后颅内感染的常规手段进行推广。OBJECTIVE To investigate the prevention effects of conventional lumbar puncture in patients with intracranial infections after craniotomy operation,so as to guide prevention and treatment of intracranial infections after surgical operation.METHODS Totally 44 patients who met the diagnostic criteria of intracranial infections after operation were chosen.A total of 18 patients with conventional antimicrobial therapy were chosen as control group.On the basis of routine treatment,26 patients who were treated with daily routine lumbar puncture to release the infected cerebrospinal fluid and intrathecal injection of antibiotics were regarded as lumbar puncture group.The clinical indexes of the two groups were compared and the results were statistically analyzed by Excel.RESULTS In the lumbar puncture group,totally 25 infected cases were cured and the curative rate was 96.15%.While there were 16 cases in the control group were cured with the curative rate of 88.89%.The curative rate in the lumbar puncture group was slightly higher than that of the control group but the differences were not significant.The body temperature,protein level in cerebrospinal fluid,the level of glucose,and the number of leukocyte in cerebrospinal fluid were compared between the two groups before and after the treatment.The differences were significant（P〈0.05）.Some patients in the lumbar puncture group appeared low back pain but the pain can be tolerated.No similar symptoms appeared in the control group.CONCLUSION The conventional puncture used to prevent and cure intracranial infections has high curative rate,good efficacy and short clinical curing time and tolerant adverse reactions therefore can be treated as routine method in controlling and curing intracranial infections after craniotomy operation promotion.

关 键 词：开颅手术 腰穿刺 颅内感染 作用 

分 类 号：R181.32[医药卫生—流行病学]