腰大池引流与腰穿联合鞘内注射替加环素治疗泛耐药鲍曼不动杆菌颅内感染疗效的对比分析  

Comparative analysis of the efficacy of lumbar cistern drainage and lumbar puncture combined with intrathecal injection of tigecycline in the treatment of pan-resistant Acinetobacter baumannii intracranial infection

作　　者：倪世慧[1] 王承 郭娜 贾宇锋[1] 赵立伟[1] 王继庆[1] Ni Shi-hui;Wang Cheng;Guo Na;Jia Yu-feng;Zhao Li-wei;Wang Ji-qing(Xinhua Hospital Affiliated to Dalian University,Dalian 410208,China;Changsha Traditional Chinese Medicine Hospital/Changsha Eighth Hospital,Changsha 410100,China)

机构地区：[1]大连大学附属新华医院,大连410208 [2]长沙市中医医院/长沙市第八医院神经外科,长沙410100

出　　处：《湖南师范大学学报（医学版）》2022年第2期104-107,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:分析腰大池引流与腰穿联合鞘内注射替加环素治疗泛耐药鲍曼不动杆菌颅内感染疗效的对比分析.方法:研究对象选择于我院神经外科在2016年1月~2021年5月收治的16例泛耐药鲍曼不动杆菌颅内感染患者.通过随机双盲分组法将研究对象分为两组,对照组和研究组,对照组采取传统的静脉应用抗生素联合间断腰穿鞘内注射抗生素,研究组采取静脉应用抗生素联合持续腰大池引流鞘内注射抗生素治疗.比较两组患者的疗效,包括临床症状、体征缓解情况,各项感染指标包括脑脊液指标(有核细胞数、中性粒细胞百分比、葡萄糖、蛋白质)与血液化验指标(白细胞数、中性粒百分比、C反应蛋白、降钙素原)改善情况及治愈率.结果:研究组的临床症状、体征缓解用时短于对照组;治疗前两组的脑脊液指标、血液化验指标均无显著差异,治疗后得到显著改善;研究组在治疗后的脑脊液有核细胞数、蛋白质浓度以及血常规白细胞数、中性粒百分比、C反应蛋白、降钙素原均低于对照组,脑脊液葡萄糖浓度高于对照组,脑脊液中性粒细胞百分比与对照组无显著差异.研究组的治愈率高于对照组,但差异无统计学意义.结论:采用腰大池引流联合鞘内注射替加环素治疗泛耐药鲍曼不动杆菌颅内感染,能够缩短临床症状、体征缓解用时,显著改善患者的脑脊液与血液化验指标,可快速控制感染,提高治愈率,较间断腰穿鞘内注射更具优势,疗效更佳.Objective To analyze the efficacy of lumbar cistern drainage and lumbar puncture combined with intrathecal injection of tigecycline in the treatment of pan-resistant Acinetobacter baumannii intracranial infection.Methods The subjects of this study were selected from 16 patients with pan-drug resistant Acinetobacter baumannii intracranial infection who were admitted to the Department of Neurosurgery of our hospital from January 2016 to May 2021.The study subjects were equally divided into two groups by randomized double-blind grouping,which were the control group with traditional intravenous antibiotics combined with intermittent lumbar puncture and intrathecal antibiotics,and the control group with intravenous antibiotics combined with continuous lumbar drainage and intrathecal antibiotics,research group.The curative effects of the two groups of patients were compared,including the relief of clinical symptoms and signs,and various infection indicators including cerebrospinal fluid indicators(nucleated cells,percentage of neutrophils,glucose,protein)and blood test indicators(number of white blood cells,percentage of neutrophils),C-reactive protein,procalcitonin)to improve the condition and cure rate.Results The clinical symptoms and signs of the study group took shorter time than the control group.Before treatment,there was no significant difference in cerebrospinal fluid indexes and blood test indexes between the two groups,and both were significantly improved after treatment.The number of nucleated cells,protein concentration and protein concentration in the cerebrospinal fluid of the study group after treatment The number of blood white blood cells,the percentage of neutrophils,C-reactive protein,and procalcitonin were all lower than those of the control group.The glucose concentration of cerebrospinal fluid was higher than that of the control group.The percentage of neutrophils in the cerebrospinal fluid was compared with the control group.There was no significant difference between the groups.The cure rate of

关 键 词：腰大池引流 腰穿 鞘内注射 替加环素 泛耐药鲍曼不动杆菌 颅内感染 

分 类 号：R516[医药卫生—内科学]