神经内镜联合不同抗菌药物治疗脑室-腹腔分流术后颅内感染的疗效分析  

Effect of neuroendoscopy combined with different antibiotics on treatment of intracranial infections after ventricle-peritoneal shunt

作　　者：甘晓[1] 张东波[2] 刘向业[1] 傅刘鹏[3] 白新学[2] 

机构地区：[1]南阳市中心医院创伤外科,河南南阳473009 [2]南阳市中心医院神经外科,河南南阳473009 [3]南阳市中心医院临床药学科,河南南阳473009

出　　处：《中华医院感染学杂志》2016年第22期5156-5158,共3页Chinese Journal of Nosocomiology

基　　金：河南省教育厅科学技术研究重点项目(142182310045)

摘　　要：目的探讨神经内镜对脑室-腹腔分流手术后颅内感染患者的应用效果,研究对炎性应激状态的影响,为减少术后并发症提供参考依据。方法选取2014年1月-2015年12月收治的70例脑室-腹腔分流术后颅内感染患者,随机分为两组,即试验组和对照组,每组患者35例;两组患者均探入内镜,将脑室段分流管拔出,术后行脑室外引流;术后对照组患者给予盐酸万古霉素,试验组患者给予利奈唑胺,评价两种治疗方法的有效性及安全性。结果术前相比,治疗后两组患者脑脊液WBC、蛋白含量表达水平均显著降低(P<0.05),葡萄糖含量显著升高(P<0.05);外周血ESR、PCT及CRP表达水平均显著降低(P<0.05)。和对照组患者相比,治疗后试验组患者脑脊液WBC、蛋白含量表达水平均显著降低(P<0.05),葡萄糖含量显著升高(P<0.05);外周血ESR、PCT及CRP表达水平均显著降低(P<0.05)。结论采用神经内镜联合利奈唑胺治疗脑室-腹腔分流手术后颅内感染取得了良好的临床疗效,可有效控制炎症应激状态,值得临床推广。OBJECTIVE To explore the effect of neuroendoscopy on treatment of postoperative intracranial infec‐tions in patients undergoing ventricle‐peritoneal shunt and observe the influence on inflammatory stress state so as to reduce the incidence of postoperative complications .METHODS A total of 70 patients who received the ventricle‐peritoneal shunt from Jan 2014 to Dec 2015 and had postoperative intracranial infections were enrolled in the study and randomly divided into the experimental group and the control group ,with 35 cases in each group .The neuro‐endoscopes were probed into the two groups of patients so as to pull out the shunt of ventricle segment ,and the ventricular drainage was carried out after the surgery ;the control group was treated with vancomycin hydrochlo‐ride;the experimental group was treated with linezolid .RESULTS The WBC counts and level of expression of pro‐tein in cerebrospinal fluid remarkably declined in the two groups of patients after the treatment （P〈 .005）;the glucose content was significantly elevated （P〈0 .05） .The levels of expression of ESR ,PCT ,and CRP in periph‐eral blood were remarkably reduced （P〈0 .05） .As compared with the control group ,the WBC counts and level of expression of protein in cerebrospinal fluid remarkably declined in the experimental group after the treatment （P〈0 .05） ,the glucose content was significantly elevated （P〈0 .05）;the levels of expression of ESR ,PCT ,and CRP in peripheral blood were remarkably reduced （P〈0 .05） .CONCLUSION The neuroendoscopy combined with lin‐ezolid can achieve significant effect on treatment of the postoperative intracranial infections in the patients undergo‐ing ventricle‐peritoneal shunt and effectively control the inflammatory stress state ,and it is worthy to be promoted in the hospital .

关 键 词：神经内镜 脑室-腹腔分流术 颅内感染 炎性应激状态 

分 类 号：R651.11[医药卫生—外科学]