静脉滴注联合鞘内/脑室内注射多粘菌素治疗颅内多重耐药菌感染有效性和安全性的Meta分析  

Meta⁃analysis of efficacy and safety of intravenous combined with intrathecal/intraventricular injection of polymyxin against intracranial infection with multidrug⁃resistant bacteria

作　　者：周益毅 龙勇[1] 谢尊椿 王联群[1] 洪道俊[1] ZHOU Yiyi;LONG Yong;XIE Zunchun(Department of Neurology,The First Affiliated Hospital,Jiangxi Medical College,Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学江西医学院第一附属医院神经内科,330006

出　　处：《临床神经病学杂志》2024年第1期15-19,共5页Journal of Clinical Neurology

摘　　要：目的评价静脉滴注(IV)联合鞘内/脑室内注射(ITH/IVT)多粘菌素治疗颅内多重耐药菌感染的有效性及安全性。方法计算机检索万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库、Pubmed、Embase、ScienceDirect及Cochrane Library,筛选2023年1月前有关IV+ITH/IVT多粘菌素治疗颅内多重耐药菌感染的队列研究。采用RevMan 5.4软件进行Meta分析。结果最终纳入9项回顾性临床研究。IV+ITH/IVT组病死率显著低于IV组(OR=0.19,95%CI:0.11~0.35,P<0.01)。IV+ITH/IVT组与IV组ICU住院天数(OR=-2.32,95%CI:-23.59~18.89,P=0.83)及不良反应率(OR=0.93,95%CI:0.26~3.38,P=0.91)差异无统计学意义。结论IV+ITH/IVT多粘菌素治疗颅内多重耐药菌感染可以显著降低患者病死率,且不显著增加不良反应。Objective Evaluation of the efficacy and safety of intravenous(IV)combined with intrathecal/intraventricular injection(ITH/IVT)of polymyxin against intracranial infection with multidrug⁃resistant bacteria.Methods The databases,including Wanfang,VIP,Chinese Biomedical Literature,Pubmed,Embase,ScienceDirect,and Cochrane Library were searched,case⁃control studies on IV+ITH/IVT polymyxin against intracranial infection with multidrug⁃resistant bacteria by January 2023 were screen.RevMan 5.4 software was used for meta⁃analysis.Results A total of 9 retrospective studies were included.The fatality rate in IV+ITH/IVT polymyxin group was significantly lower than that in IV group(OR=0.19,95%CI:0.11-0.35,P<0.01).There was no significant difference in ICU hospitalization days(OR=-2.32,95%CI:-23.59-18.89,P=0.83)and adverse reaction rate(OR=0.93,95%CI:0.26-3.38,P=0.91)between IV+ITH/IVT group and IV group.Conclusion IV+ITH/IVT polymyxin in treating the intracranial infection with multidrug⁃resistant bacteria can significantly reduce fatality rate,and does not significantly increase adverse reactions.

关 键 词：多粘菌素 颅内感染 鞘内注射 脑室内注射 META分析 

分 类 号：R51[医药卫生—内科学]