鞘内注射与静脉滴注抗生素治疗重型颅脑损伤继发颅内感染的临床效果  

Clinical effects of intrathecal injection and intravenous drip of antibiotics in the treatment of secondary intracranial infection after severe craniocerebral injury

作　　者：吕智贵 林县杰 LYU Zhi-gui;LIN Xian-jie(Intensive Care Medicine,Zhongshan Torch Development Zone Hospital,Guangdong Province,Zhongshan528437,China;Department of Critical Care Medicine,Dongfeng People′s Hospital,Guangdong Province,Zhongshan528425,China)

机构地区：[1]广东省中山火炬开发区医院重症医学科,广东中山528437 [2]广东省中山市东凤人民医院重症医学科,广东中山528425

出　　处：《中国当代医药》2021年第13期102-105,共4页China Modern Medicine

摘　　要：目的探讨鞘内注射与静脉滴注抗生素治疗重型颅脑损伤继发颅内感染的临床效果。方法选取2018年1月~2020年1月中山火炬开发区医院收治的120例重型颅脑损伤继发颅内感染患者作为研究对象,采用随机数字表法将其分为观察组与对照组,每组各60例。对照组在常规治疗基础上全身静脉滴注万古霉素、美罗培南,观察组则在常规治疗基础上采取鞘内注射的方式应用万古霉素、美罗培南。比较两组临床治疗效果及预后、安全情况。结果观察组治疗后总有效率高于对照组,退热时间、白细胞恢复正常时间、治愈时间短于对照组,治疗总费用低于对照组,差异有统计学意义(P<0.05)。治疗前,两组脑脊液高迁移率族蛋白-1(HMGB-1)、晚期糖基化终产物受体(RAGE)指标比较,差异无统计学意义(P>0.05);治疗7 d后,观察组HMGB-1、RAGE指标低于对照组,差异有统计学意义(P<0.05)。观察组不良反应及后遗症发生率低于对照组,差异有统计学意义(P<0.05)。结论鞘内注射抗生素治疗重型颅脑损伤继发颅内感染可有效、快速控制患者感染病情,临床疗效更为显著,且治疗后不良反应以及后遗症发生风险更低,具有临床应用及推广价值。Objective To investigate the clinical efficacy of intrathecal injection and intravenous drip of antibiotics in the treatment of secondary intracranial infection after severe craniocerebral injury.Methods A total of 120 patients with severe craniocerebral injury secondary intracranial infection admitted to Zhongshan Torch Development Zone Hospital were selected as the research objects.They were divided into observation group and control group by random number table method,with 60 cases in each group.The control group was given systemic intravenous drip of vancomycin and meropenem on the basis of conventional treatment,while the observation group was given intrathecal injection of vancomycin and meropenem on the basis of conventional treatment.The clinical therapeutic effect,prognosis and safety of the two groups were compared.Results The total effective rate of the observation group was higher than that of the control group,the time of fever reduction,white blood cell return to normal and cure time were shorter than that of the control group,and the total cost of treatment was lower than that of the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the indexes of high mobility group protein-1(HMGB-1)and receptor for advanced glycation end products(RAGE)in cerebrospinal fluid of the two groups(P>0.05),the HMGB-1 and RAGE indexes of the observation group were lower than those of the control group after 7 days of treatment,the differences were statistically significant(P<0.05).The incidence of adverse reactions and sequelae in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion Intrasheath injection of antibiotics in the treatment of intracranial infection secondary to severe craniocerebral injury can effectively and quickly control the patient′s infection condition,with more significant clinical efficacy and lower risk of adverse reactions and sequelae after treatment,

关 键 词：鞘内注射 全身静脉滴注 抗生素疗法 重型颅脑损伤 临床疗效 不良反应 后遗症 

分 类 号：R741[医药卫生—神经病学与精神病学]