万古霉素不同用药方式联合美罗培南治疗颅脑术后颅内感染的效果比较  

Comparison on Efficacy of Different Administration Methods of Vancomycin Combined with Meropenem in the Treatment of Intracranial Infection After Craniotomy

作　　者：张亚平 刘志文 ZHANG Yaping;LIU Zhiwen(Department of Pharmacy,Xiping People’s Hospital,Zhumadian 463900,China;Department of Respiratory and Critical Care Medicine,Xiping People’s Hospital,Zhumadian 463900,China)

机构地区：[1]西平县人民医院药剂科,河南驻马店463900 [2]西平县人民医院呼吸与危重症医学科,河南驻马店463900

出　　处：《河南医学研究》2021年第33期6259-6261,共3页Henan Medical Research

摘　　要：目的探讨万古霉素不同用药方式联合美罗培南治疗颅脑术后颅内感染的效果。方法选取2019年7—12月至西平县人民医院就诊的52例颅脑术后颅内感染患者为研究对象。采用随机数字表法分为两组,各26例。对照组接受美罗培南联合万古霉素静脉滴注治疗,观察组接受美罗培南联合万古霉素鞘内注射治疗。两组均治疗12 d。比较两组治疗期间发热、乏力、食欲不振、全身酸疼等临床症状控制时间。比较治疗前、治疗12 d的炎症因子水平[脑脊液白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及血清降钙素原(PCT)]。结果治疗期间,观察组发热、乏力、食欲不振、全身酸疼的临床症状控制时间早于对照组,差异有统计学意义(P<0.05)。治疗12 d,两组患者脑脊液IL-6、TNF-α、血清PCT水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。结论美罗培南联合万古霉素鞘内注射治疗颅脑损伤术后颅内感染患者可有效抑制炎症反应,促进临床症状的缓解。Objective To investigate the efficacy of different administration methods of vancomycin combined with meropenem in the treatment of intracranial infection after craniotomy.Methods Fifty-two patients with intracranial infection after craniotomy in Xiping People’s Hospital from July to December 2019 were selected as the research subjects.A random number table method was used to divide them into two groups,with 26 cases in each group.The control group was treated with meropenem combined with vancomycin intravenous drip,and the observation group was treated with meropenem combined with vancomycin intrathecal injection.Both groups were treated for 12 days.The control time of clinical symptoms such as fever,fatigue,loss of appetite and general pain were compared between the two groups.The levels of inflammatory factors[cerebrospinal fluid interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and serum procalcitonin(PCT)]were compared before and 12 days after treatment.Results During the treatment period,the control time of clinical symptoms of fever,fatigue,loss of appetite and systemic pain in observation group were earlier than those in control group(P<0.05).After 12 days of treatment,the levels of cerebrospinal fluid IL-6,TNF-αand serum PCT of patients in both groups were decreased than those before treatment,and the indexes in observation group was lower with the comparison of control group(P<0.05).Conclusion Meropenem combined with vancomycin intrathecal injection in the treatment of patients with intracranial infection after craniocerebral injury can effectively inhibit the inflammatory reaction and promote the relief of clinical symptoms.

关 键 词：颅内感染 万古霉素 美罗培南 静脉滴注 鞘内注射 炎症因子 

分 类 号：R651[医药卫生—外科学]