腰大池持续引流联合静脉抗菌药物治疗神经外科患者术后颅内感染  

Clinical Effect of Continuous Drainage Combined with Intravenous Antibacterial Drugs for Postoperative Intracranial Infection in Neurosurgical Patients

作　　者：闫峰 杨荣刚 YAN Feng;YANG Ronggang(Department of Neurosurgery,Nanshi Hospital in Nanyang,Nanyang 473000,China)

机构地区：[1]南阳南石医院神经外科,河南南阳473000

出　　处：《湖北民族大学学报（医学版）》2023年第4期48-50,54,共4页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的评价腰大池持续引流+静脉抗菌药物治疗对神经外科患者术后颅内感染的治疗效果。方法选择南阳南石医院神经外科2018年3月-2023年1月收治的70例术后颅内感染患者,根据治疗方法不同分为对照组35例与观察组35例。对照组开展静脉抗菌药物治疗,观察组开展腰大池持续引流+静脉抗菌药物治疗,治疗后,对比两组临床效果、病原菌检出率、颅内压及治疗前后脑脊液指标。统计治疗前后C反应蛋白(CRP)与降钙素原(PTC)变化情况。结果观察组总有效率明显高于对照组(χ^(2)=4.629,P<0.05)。治疗后观察组白细胞计数、蛋白质含量明显低于对照组,葡萄糖含量明显高于对照组(P<0.05)。治疗后,观察组CRP、PCT水平明显低于对照组(P<0.05)。结论在神经外科患者手术后给予腰大池持续引流+静脉抗菌药物治疗可有效降低颅内感染发生风险,可显著改善脑脊液指标,抑制炎症,有助于预防术后颅内感染的发生。Objective After the application of continuous drainage and intravenous antimicrobial therapy,the treatment effect of postoperative intracranial infection in neurosurgery patients was evaluated.Methods 70 patients with postoperative intracranial infections admitted to the hospital from March 2018 to January 2023 were selected and divided into a control group and an observation group according to the treatment method,with 35 cases in each group.The control group carried out intravenous antimicrobial therapy,and the observation group carried out continuous drainage of lumbar large pool+intravenous antimicrobial treatment.After treatment,the clinical effect,pathogen detection rate,intracranial pressure and cerebrospinal fluid index before and after treatment of the two groups were compared.The changes of C-reactive protein(CRP)and and procalcitonin(PTC)before and after treatment were analyzed.Results Compared with the control group of 71.43%,the total response rate in the observation group was 91.43%,with visible differences between the groups(χ^(2)=4.629,P<0.05).After treatment,the glucose content in the observation group was(4.77±0.60)mmol/L,which was significantly higher than that in the control group(3.17±0.61)mmol/L,and the difference was statistically significant(t=11.063,P<0.05).Compared with the control group,the observation group was lower in white ocyte count,intracranial pressure detection,and protein and pathogen detection(P<0.05).Before treatment,there was no difference between the CSF indexes of the two groups(P>0.05).After treatment,the CRP and PCT levels decreased in the observation group,which were better than those in the control group(P<0.05).Conclusion Continuous drainage of lumbar large pool+intravenous antimicrobial therapy in neurosurgical patients can effectively reduce the risk of intracranial infection,which can significantly improve cerebrospinal fluid index,inhibit inflammation,and prevent the occurrence of postoperative intracranial infection.

关 键 词：腰大池 持续引流 抗菌药物 颅内感染 

分 类 号：R651.15[医药卫生—外科学]