儿童结核性脑膜炎鞘内注药的临床效果分析  

Clinical effect analysis of intrathecal administration in children with tuberculous meningitis

作　　者：贝力克孜·艾合坦木 张荣民[2] 阿不都亥力力·依马木 闫树丽 Beilikezi Aihetanmu;ZHANG Rong-min;Abuduhailili Yimamu(Department of Pediatric Intensive Care,Xinjiang Aksu First People’s Hospital,Aksu 843000,China)

机构地区：[1]新疆阿克苏地区第一人民医院儿童重症医学科,843000 [2]新疆阿克苏地区第一人民医院儿童病案室,843000 [3]新疆阿克苏地区第一人民医院心胸外科,843000

出　　处：《临床神经病学杂志》2021年第3期207-210,共4页Journal of Clinical Neurology

摘　　要：目的探讨儿童结核性脑膜炎鞘内注药的临床效果及安全性。方法收集2010年1月至2019年12月期间在我院儿科住院结核性脑膜炎110例,按治疗方法分为观察组与对照组,每组55例。对照组给予常规抗结核药物及地塞米松静脉注射治疗,观察组在对照组治疗方案的基础上同时给予地塞米松联合异烟肼鞘内注射治疗。观察两组临床表现转归时间、住院时间及治疗后CSF指标的改变情况,并评价安全性。结果观察组临床疗效明显高于对照组(P<0.001)。观察组临床表现转归时间及住院时间均明显短于对照组(均P<0.001)。两组开始抗结核药物治疗1周后CSF指标对比,观察组细胞数、蛋白质的降低和葡萄糖、氯化物的升高均明显优于对照组(P<0.05,P<0.001)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论鞘内注药治疗在儿童结核性脑膜炎中早期应用效果显著,可缩短病程,改善预后,安全性较高。Objective To investigate the clinical effect and safety of intrathecal administration in children with tuberculous meningitis.Methods A total of 110 cases of tuberculous meningitis hospitalized in our hospital from January 2010 to December 2019 were collected and divided into observation group and control group according to treatment methods,with 55 cases in each group.The control group was given conventional anti-tuberculosis drugs and intravenous administration of dexamethasone,and the observation group was also given dexamethasone combined with intrathecal administration of isoniazid on the basis of the treatment plan of the control group.The clinical outcome time,length of hospital stay and changes in CSF indexes after treatment in the two groups were observed,and the safety was evaluated.Results The clinical efficacy of observation group was significantly higher than that of control group(P<0.001).The duration of clinical outcome and hospitalization in the observation group were significantly shorter than those in the control group(all P<0.001).Comparison of CSF indexes between the two groups after 1 week of antituberculous drug treatment showed that the decreases of cell number,protein and the increases of glucose and chloride in the observation group were significantly better than those in the control group(P<0.05,P<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Intrathecal administration is effective in early treatment of tuberculous meningitis in children,which can shorten the course of disease and improve the prognosis,and has high safety.

关 键 词：结核性脑膜炎 鞘内注药 异烟肼 地塞米松 儿童 

分 类 号：R529.3[医药卫生—内科学]