鞘内注射异烟肼加地塞米松同时等量生理盐水置换治疗结核性脑膜炎的价值  

Value of intrathecal isoniazid and dexamethasone combined with equal amount of normal saline replacement in the treatment of tuberculous meningitis

作　　者：白洪忠[1] 韩玮欣 张雪萍[3] 李敬[2] 李雯[4] BAI Hong-zhong;HAN Wei-xin;ZHANG Xue-ping;LI Jing;LI Wen(President′s Office,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Neurology,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Obstetrics and Gynecology,Hebei Chest Hospital,Shijiazhuang 050041,China;Department of Imaging,Hebei Chest Hospital,Shijiazhuang 050041,China)

机构地区：[1]河北省胸科医院院办室,河北石家庄050041 [2]河北省胸科医院神经内科,河北石家庄050041 [3]河北省胸科医院妇产科,河北石家庄050041 [4]河北省胸科医院影像科,河北石家庄050041

出　　处：《河北医科大学学报》2020年第1期21-23,33,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20150139)

摘　　要：目的探讨鞘内注射异烟肼加地塞米松同时等量生理盐水置换治疗结核性脑膜炎的价值。方法将结核性脑膜炎患者78例随机分为对照组(鞘内注射异烟肼加地塞米松治疗)和观察组(在对照组基础上联合等量生理盐水置换治疗),比较2组治疗效果。结果治疗后,2组脑脊液中蛋白、葡萄糖、细胞计数含量均较治疗前降低,观察组脑脊液氯化物含量较治疗前降低(P<0.05)。治疗后,观察组脑脊液中蛋白、葡萄糖、细胞计数和氯化物含量均较对照组降低(P<0.05)。观察组总有效率高于对照组(P<0.05)。观察组药物不良反应率低于对照组(P<0.05)。观察组头痛颈强消失、脑脊液压力恢复、发热消失、呕吐消失、昏迷恢复、脑脊液蛋白含量恢复、脑脊液细胞含量恢复时间及住院时间均短于对照组(P<0.05)。结论对结核性脑膜炎患者采用鞘内注射异烟肼加地塞米松同时等量生理盐水置换治疗,临床治疗效果明确,临床指标、症状明显改善,在确保治疗安全的同时缩短了住院时间,为早期康复提供了保障。Objective To analyze the value of intrathecal injection of isoniazid plus dexamethasone combined with saline replacement in the treatment of tuberculous meningitis.Methods A total of 78 patients with tuberculous meningitis were selected.They were randomly divided into reference group(intrathecal injection of isoniazid plus dexamethasone)and observation group(control group combined with equal amount of normal saline replacement treatment).The therapeutic effects of the two groups were compared.Results After treatment,content of protein,glucose and cell count in cerebrospinal fluid(CSF)of the two groups were lower than that before treatment,and content of chloride in CSF of the observation group was lower than that before treatment(P<0.05).After treatment,contents of protein,glucose,cell count and chloride in CSF of the observation group were all lower than that of control group(P<0.05).The total effective rate of observation group was higher than that of control group(P<0.05).The adverse drug reaction rate of observation group was lower than that of control group(P<0.05).The recovery time of headache and neck strength,CSF pressure,fever,vomiting,coma,CSF protein,CSF cell and hospitalization in the observation group were significantly shorter than those in control group(P<0.05).Conclusion The treatment of tuberculous meningitis by intrathecal injection of isoniazid plus dexamethasone and replacement with equal amount of normal saline has clear clinical effect,obvious improvement of clinical indicators and symptoms,ensuring the safety of treatment,shortening the length of stay and providing guarantee for early rehabilitation.

关 键 词：结核 脑膜 异烟肼 地塞米松 生理盐水 

分 类 号：R529.3[医药卫生—内科学]