腰大池引流联合鞘内万古霉素注射在颅内感染中的应用
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摘要
目的探讨腰大池引流联合鞘内万古霉素注射在颅内感染中的应用效果。方法对开颅术后颅内感染38例患者给予腰大池引流联合鞘内万古霉素注射治疗。结果 38例患者经改良Rankin量表评分:其中恢复良好24例(63.1%),m Rs为0~1,轻度残疾6例(15.8%),m Rs为2,中度残疾5例(13.1%),m RA为3,重度残疾1例(2.6%),m Rs为4,植物状态生存1例(2.6%),m Rs为5,死亡1例(2.6%)。结论腰大池引流联合鞘内万古霉素注射对于颅内感染患者是有效并切实可行的,可提高治愈率,降低病死率,具有经济、便于操作等优点。
Objectives Discussion of application of integration of lumbar cisterna drainage and intrathecal vancomycin injection in intracrainial infection.Methods Conduct retrospective analysis of clinical materials of 38 patients who got intracrainial infection after crainotomy and were provided with integration of lumbar cisterna drainage and intrathecal vancomycin injection.Results 38 patients were scored by modified Rankin Scale:good recovery 24cases(63.1%),m Rs was 0-1,slight disability 6 cases(15.8%),m Rs was 2,moderate disability 5 cases(13.1%),m Rs was 3,severe disability 1 case(2.6%),m Rs was 4,vegetative 1 case(2.6%),m Rs was 5,death 1 case(2.6%).Conclusion Integration of lumbar cisterna drainage and intrathecal vancomycin injection are effective and practical for intracrainial infection patients,it can improve recovery rate of intracrainial infection and reduce death rate. It is economical and easy to be operated.
Objectives Discussion of application of integration of lumbar cisterna drainage and intrathecal vancomycin injection in intracrainial infection.Methods Conduct retrospective analysis of clinical materials of 38 patients who got intracrainial infection after crainotomy and were provided with integration of lumbar cisterna drainage and intrathecal vancomycin injection.Results 38 patients were scored by modified Rankin Scale:good recovery 24cases(63.1%),m Rs was 0-1,slight disability 6 cases(15.8%),m Rs was 2,moderate disability 5 cases(13.1%),m Rs was 3,severe disability 1 case(2.6%),m Rs was 4,vegetative 1 case(2.6%),m Rs was 5,death 1 case(2.6%).Conclusion Integration of lumbar cisterna drainage and intrathecal vancomycin injection are effective and practical for intracrainial infection patients,it can improve recovery rate of intracrainial infection and reduce death rate. It is economical and easy to be operated.
引文
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[10]刘宝来,田双奎,田俊敏,等.腰大池置管持续引流治疗颅内感染疗效分析[J].中国实用医药,2009,4(12):127-128.
[2]霍云燕,刘存义,崔京美.颅脑外伤患者医院感染相关因素研究[J].中华医院感染学杂志,2010,20(21):3312-3313.
[3]李瑞龙,郝解贺.开颅术后颅内感染相关危险因素分析[J].山西医科大学学报,2011,42(6):510-513.
[4]徐秀华.临床医院感染学(修订版)[M].长沙:湖南科学技术出版社,2005:247-250.
[5]荆楠,唐明忠,刘志忠,等.神经外科术后颅内感染脑脊液病原菌分布和耐药性分析[J].中国实验诊断学,2012,16(7):1272-1274.
[6]蔡建勇,孙军,陈茂华,等.颅脑外伤后肺部感染患者病原菌耐药性分析[J].中华医院感染学杂志,2010,20(22):3615-3617.
[7]白治军,王志扬.鞘内给药治疗神经外科术后颅内感染的临床观察[J].白求恩军医学院学报,2011,9(4):282-283.
[8]Pfausler B,Haring HP,Kampfl A,et al.Cerebrospinal fluid(CSF)pharmacokinetics of intraventricular vancomycin in patients with staphylococcal ventriculitis associated with external CSF drainage[J].Clin Infect Dis,1997,25(3):733-752.
[9]钟德泉,徐伟光,殷利明,等.万古霉素鞘内注射治疗脑出血引流术后颅内感染[J].中国医药科学,2012,2(14):49.
[10]刘宝来,田双奎,田俊敏,等.腰大池置管持续引流治疗颅内感染疗效分析[J].中国实用医药,2009,4(12):127-128.