脑脊液置换联合鞘内注药治疗结核性脑膜炎临床分析  

Analysis and research on the therapeutic value of cerebrospinal fluid replacement combined with intrathecal drug injection for tuberculous meningitis

作　　者：陈永芳[1] 任鹏飞[1] 陈裕[1] CHEN Yongfang;REN Pengfei;CHEN Yu(Elderly TB Division,Sixth People's Hospital of Zhengzhou,Zhengzhou 450001,China)

机构地区：[1]郑州市第六人民医院老年结核病科,河南郑州450001

出　　处：《中国实用神经疾病杂志》2018年第8期861-863,共3页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关计划项目(201702328)

摘　　要：目的研究脑脊液置换联合鞘内注药对结核性脑膜炎的治疗价值。方法选取2015-01—2016-06结核性脑膜炎患者76例,将其随机分2组。常规治疗组用常规抗结核方法进行治疗,联合治疗组在常规治疗组基础上采用脑脊液置换联合鞘内注药治疗。比较2组治疗总有效率,不良反应发生率;治疗前和治疗后患者脑脊液压力、脑脊液白细胞数、蛋白定量的差异。结果 2组患者治疗的总有效率有明显差异,联合治疗组高于常规治疗组,P<0.05;2组不良反应发生率无明显差异(P>0.05);2组患者的脑脊液白细胞数、脑脊液压力、蛋白定量等基线数据比较差异无统计学意义(P>0.05);治疗后联合治疗组脑脊液压力、脑脊液白细胞数、蛋白定量改善幅度更大,P<0.05。结论脑脊液置换联合鞘内注药对治疗结核性脑膜炎具有明显的临床价值,可有效改善脑脊液情况,降低蛋白定量,无明显不良反应,对患者预后和转归有益,值得推广。Objective To study the therapeutic value of cerebrospinal fluid replacement combined with intrathecal drug injection for tuberculous meningitis.Methods 76 cases of tuberculous meningitis were selected from January 2015 to June 2016 and randomly divided into two groups.Conventional treatment group was treated with conventional anti tuberculosis therapy,and the treatment group was treated with cerebrospinal fluid re placement combined with intrathecal drug injection therapy on the basis of the conventional treatment group.The total effective rate and the adverse effect rate of tuberculous meningitis,the difference of pressure,white blood cell count and protein quantification in cerebrospinal fluid before and after treatment were compared between the two groups.Results Patients with tuberculous meningitis treatment the total effective rate of the two groups have significant differences,treatment group was higher than conventional treatment group(P<0.05),there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).There was no statistical difference in the baseline data of CSF,cerebrospinal fluid pressure and protein quantification in the two groups(P>0.05).The pressure,white blood cell count and protein quantification in cerebrospinal fluid of the combined treatment group improved greater than the conventional treatment group after treatment(P<0.05).Conclusion Cerebrospinal fluid replacement combined with intrathecal injection has obvious clinical value in the treatment of tuberculous meningitis.It can effectively improve the cerebrospinal fluid condition via decreasing protein quantification with no obvious adverse effect.It can promote better prognosis and outcome and is worth popularizing.

关 键 词：脑脊液置换 鞘内注药 结核性脑膜炎 治疗价值 研究 

分 类 号：R529.3[医药卫生—内科学]