持续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患者的效果及其对脑脊液指标的影响  

Effect of continuous lumbar cisterna drainage combined with intrathecal injection of tegacycline on intracranial infection of Pandrug-resistant Acinetobacter baumannii and its influence on cerebrospinal fluid indexes

作　　者：王向蒙 冯阳 韩婉青 Wang Xiangmeng;Feng Yang;Han Wanqing(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学第一附属医院,河南洛阳471000

出　　处：《辽宁医学杂志》2024年第4期37-41,共5页Medical Journal of Liaoning

摘　　要：目的探究持续腰大池引流联合鞘内注射替加环素对泛耐药鲍曼不动杆菌致颅内感染患者的应用效果。方法选取我科87例泛耐药鲍曼不动杆菌颅内感染患者,根据抽签法分组。对照组43例给予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,观察组44例给予静脉应用抗生素联合持续腰大池引流联合鞘内注射替加环素治疗,对比疗效。结果两组28d死亡率无统计学意义(P>0.05);观察组脑膜刺激征缓解用时、体温恢复正常用时、颅内压升高缓解用时均短于对照组,脑脊液有核细胞数、中性粒细胞百分比、蛋白质水平低于对照组,葡萄糖水平高于对照组,血液白细胞数、C反应蛋白、中性粒百分比、降钙素原水平均低于对照组(P<0.05)。结论持续腰大池引流联合鞘内注射替加环素对泛耐药鲍曼不动杆菌颅内感染患者治疗,可有效缩短临床症状缓解时间,调节脑脊液指标,降低死亡率和炎症反应。Objective To investigate the effect of continuous lumbar cisterna drainage combined with intrathecal injection of tegacycline on intracranial infection caused by pan-drug resistant Acinetobacter baumannii.Methods Eighty-seven patients with intracranial infection of pandrug-resistant Acinetobacter baumannii in our department were selected and grouped according to the lottery method.Forty-three patients in the control group were treated with traditional intravenous antibiotics combined with intermittent intrathecal injection of antibiotics,while 44 patients in the observation group were treated with intravenous antibiotics combined with continuous lumbar cisterna drainage combined with intrathecal injection of tigacycline.Results There was no statistical significance in 28d mortality between the two groups(P>0.05).The duration of meningeal stimulation relief,temperature recovery and intracranial hypertension relief in the observation group were shorter than those in the control group.The number of nucleated cells,percentage of neutrophil and protein level in cerebrospinal fluid were lower than those in the control group,while the glucose level was higher.The number of white blood cells,C-reactive protein,percentage of neutrophil and raw calcitonin in blood were lower than those in the control group on average.There was statistical significance(P<0.05).Conclusion Continuous lumbar cisterna drainage combined with intrathecal injection of tegacycline can effectively shorten the duration of clinical symptom relief,regulate cerebrospinal fluid indexes,and reduce mortality and inflammation in patients with pan-drug-resistant Acinetobacter baumannii intracranial infection.

关 键 词：腰大池引流 鞘内注射 颅内感染 鲍曼不动杆菌 替加环素 

分 类 号：R742.9[医药卫生—神经病学与精神病学]