开颅手术后颅内感染患者脑脊液置换联合不同药物鞘内注射治疗的疗效研究  

Efficacies of cerebrospinal fluid replacement combined with intrathecal injection of different drugs in treatment of craniotomy patients with postoperative intracranial infections

作　　者：单小松[1] 丁亚楠[1] 王冀伟[1] 杜磊[1] 刘海鹏[1] 

机构地区：[1]河北大学附属医院神经外科,河北保定071000

出　　处：《中华医院感染学杂志》2015年第12期2802-2804,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81101250)

摘　　要：目的对比开颅手术后颅内感染患者脑脊液置换联合不同药物鞘内注射治疗的疗效,为有效治疗提供依据。方法选取2010年3月-2014年9月治疗的86例开颅手术后颅内感染患者为研究对象,采用随机数表法将86例患者分为观察组和对照组,各43例,观察组患者给予脑脊液置换术联合万古霉素与地塞米松鞘内注射治疗,对照组患者给予脑脊液置换术和头孢曲松静脉滴注治疗,对两组患者的临床疗效、不良反应和各项脑脊液检验指标的变化进行比较。结果患者治疗后总有效率观察组为90.70%、对照组为76.74%,两组比较差异有统计学意义(P<0.05);患者的不良反应发生率观察组为4.64%、对照组为6.96%,两组比较差异有统计学意义(P<0.05);治疗后两组患者脑脊液常规、生化检验除氯化物外,其他各项指标均较治疗前改善,差异有统计学意义(P<0.05);两组患者脑脊液的各项检验指标比较差异有统计学意义(P<0.05)。结论脑脊液置换联合万古霉素和地塞米松鞘内注射能够提高临床疗效,降低不良反应发生率,可以在临床上进一步推广和使用。OBJECTIVE To compare the efficacies of the cerebrospinal fluid replacement combined with intrathecal injection of difference drugs in the treatment of the patients with postoperative intracranial infections undergoing craniotomy so as to provide guidance for effective treatment .METHODS A total of 86 patients with postoperative intracranial infections who underwent the craniotomy from Mar 2010 to Sep 2014 were recruited as the study objects and randomly divided into the observation group and the control group , with 43 cases in each . The observation group was treated with the cerebrospinal fluid replacement combined with intrathecal injection of vancomycin and dexamethasone ,while the control group was given the cerebrospinal fluid replacement combined with intravenous drip of ceftriaxone ;the clinical efficacies ,incidence of adverse reactions ,and changes of cerebro‐spinal fluid test indicators were observed and compared between the two groups of patients .RESULTS The total ef‐fective rate of treatment was 90 .70% in the observation group ,76 .74% in the control group ,and there was sta‐tistically significant difference between the two groups （P〈0 .05） .The incidence of adverse reactions was 4 .64%in the observation group ,6 .96% in the control group ,with statistical significance （P〈0 .05） .All the indicators for the cerebrospinal fluid routine examination of the two groups of patients were improved except for the chlo‐rides ,and the difference was statistically significant （P〈 0 .05） .There was statistically significant difference in the test indicators of the cerebrospinal fluid between the two groups of patients （P〈0 .05） .CONCLUSION The ce‐rebrospinal fluid replacement combined with intrathecal injection of vancomycin and examethasone may improve the clinical efficacy and reduce the incidence of adverse reactions ,and it is worthy to be promoted in the hospital .

关 键 词：脑脊液置换 鞘内注射 颅内感染 

分 类 号：R619.3[医药卫生—外科学]