脑脊液置换术联合万古霉素、地塞米松鞘内注射治疗术后颅内感染的疗效及对生化指标的影响
|
摘要
目的:探讨脑脊液置换术联合万古霉素、地塞米松鞘内注射治疗术后颅内感染的疗效及对生化指标的影响。方法:选取2014年10月—2016年10月驻马店市中心医院收治的术后颅内感染患者60例作为研究对象,按照随机数字表法分为观察组和对照组,每组各30例。对照组患者行脑脊液置换术联合静脉滴注头孢曲松治疗,观察组患者行脑脊液置换术联合鞘内注射万古霉素、地塞米松治疗。观察2组患者的疗效及生化指标变化情况。结果:治疗后,观察组患者颅内压、白细胞计数及蛋白质、葡萄糖含量均明显优于对照组,差异均有统计学意义(P<0.05);2组患者不良反应发生率的差异无统计学意义(P>0.05)。结论:脑脊液置换术联合万古霉素、地塞米松鞘内注射用于术后颅内感染患者的疗效显著,能优化患者生化指标,且不良反应较少,安全性高。
OBJECTIVE: To probe into the efficacy of cerebrospinal fluid replacement combined with intrathecal injections of vancomycin and dexamethasone in treatment of postoperative intracranial infection and effects on biochemical indexes. METHODS: 60 patients with intracranial infection after operation admitted into Zhumadian Central Hospital from Oct. 2014 to Oct. 2016 were selected to be divided into observation group and control group via the random number table,with 30 cases in each. The control group group were treated with cerebrospinal fluid replacement and intravenous ceftriaxone,while the observation group were given cerebrospinal fluid replacement and the intrathecal injection of vancomycin,dexamethasone. The efficacy and changes of biochemical indexes of two groups were observed. RESULTS: After treatment,the intracranial pressure,white blood cell count,and content of protein,glucose in observation group were significantly higher than those of control group,with statistically significant difference( P < 0. 05). There was no statistical significance between two groups in the incidence of adverse drug reactions( P >0. 05). CONCLUSIONS: The efficacy of cerebrospinal fluid replacement combined with intrathecal injections of vancomycin and dexamethasone in treatment of postoperative intracranial infection is significant,which can improve the biochemical indexes with few adverse drug reactions and high safety.
OBJECTIVE: To probe into the efficacy of cerebrospinal fluid replacement combined with intrathecal injections of vancomycin and dexamethasone in treatment of postoperative intracranial infection and effects on biochemical indexes. METHODS: 60 patients with intracranial infection after operation admitted into Zhumadian Central Hospital from Oct. 2014 to Oct. 2016 were selected to be divided into observation group and control group via the random number table,with 30 cases in each. The control group group were treated with cerebrospinal fluid replacement and intravenous ceftriaxone,while the observation group were given cerebrospinal fluid replacement and the intrathecal injection of vancomycin,dexamethasone. The efficacy and changes of biochemical indexes of two groups were observed. RESULTS: After treatment,the intracranial pressure,white blood cell count,and content of protein,glucose in observation group were significantly higher than those of control group,with statistically significant difference( P < 0. 05). There was no statistical significance between two groups in the incidence of adverse drug reactions( P >0. 05). CONCLUSIONS: The efficacy of cerebrospinal fluid replacement combined with intrathecal injections of vancomycin and dexamethasone in treatment of postoperative intracranial infection is significant,which can improve the biochemical indexes with few adverse drug reactions and high safety.
引文
[1]周振军,孙新林,文平,等.探讨降钙素原在颅脑手术术后颅内感染的诊断价值[J].中华神经医学杂志,2013,12(6):621-624.
[2]崔向丽,林松,隋大立,等.神经外科术后颅内感染的诊疗进展[J].中华神经外科杂志,2014,30(3):312-314.
[3]徐明,史中华,陈光强,等.神经外科幕上手术术后颅内感染的发生率及危险因素调查[J].中华神经外科杂志,2014,30(12):1249-1252.
[4]于焕新,刘钢.经鼻内镜下脑脊液鼻漏修补术后颅内感染因素分析[J].中华耳鼻咽喉头颈外科杂志,2014,49(2):121-124.
[5]岳晓艳,石广志.神经外科术后颅内感染患者的抗生素使用[J].首都医科大学学报,2013,34(2):177-180.
[6]陈红伟,娄元华,李小勇,等.替加环素联合头孢哌酮/舒巴坦治疗耐药鲍曼不动杆菌颅内感染临床研究[J].中国感染控制杂志,2016,15(6):384-387,392.
[7]曹海华,刘春燕,张赛,等.低温疗法联合人工脑脊液置换治疗颅内感染的安全性和有效性[J].中华危重病急救医学,2016,28(4):369-370.
[8]贾锋,阮舒,伏林山.鞘内注射万古霉素治疗神经外科术后颅内感染患者的疗效观察[J].中华医院感染学杂志,2013,23(22):5525-5526,5529.
[9]陈凯,王佳庆,武元星,等.脑室内注射万古霉素治疗术后颅内感染的方法学及药代动力学研究[J].临床神经外科杂志,2014,11(6):435-439.
[10]肖二辉,李治晓,康谊,等.腰大池引流与万古霉素鞘内疗法在颅脑外伤术后颅内感染治疗中的应用[J].中国实用神经疾病杂志,2016,19(14):125-126.
[11]王森岗,赵建奇,敬谢攀,等.万古霉素鞘内注射与腰大池引流对高血压脑出血患者术后颅内感染治疗分析[J].中华医院感染学杂志,2015,25(9):1999-2001.
[12]邹积典,郭庆雷,侯英芳,等.万古霉素治疗术后耐甲氧西林革兰阳性菌致颅内感染的疗效[J].中华医院感染学杂志,2013,23(12):2983-2985.
[13]单小松,丁亚楠,王冀伟,等.开颅手术后颅内感染患者脑脊液置换联合不同药物鞘内注射治疗的疗效研究[J].中华医院感染学杂志,2015,25(12):2802-2804.
[14]李奕锋,闫世军,韩越杨,等.腰穿与腰大池引流结合鞘内注射万古霉素治疗高血压性脑出血开颅术后颅内感染的临床疗效[J].中国老年学杂志,2015,35(5):1300-1301.
[15]彭宪星,刘芹.腰穿与腰大池引流结合鞘内注射万古霉素治疗高血压脑出血开颅术后颅内感染的疗效[J].中国实用神经疾病杂志,2016,19(10):116-117.
[2]崔向丽,林松,隋大立,等.神经外科术后颅内感染的诊疗进展[J].中华神经外科杂志,2014,30(3):312-314.
[3]徐明,史中华,陈光强,等.神经外科幕上手术术后颅内感染的发生率及危险因素调查[J].中华神经外科杂志,2014,30(12):1249-1252.
[4]于焕新,刘钢.经鼻内镜下脑脊液鼻漏修补术后颅内感染因素分析[J].中华耳鼻咽喉头颈外科杂志,2014,49(2):121-124.
[5]岳晓艳,石广志.神经外科术后颅内感染患者的抗生素使用[J].首都医科大学学报,2013,34(2):177-180.
[6]陈红伟,娄元华,李小勇,等.替加环素联合头孢哌酮/舒巴坦治疗耐药鲍曼不动杆菌颅内感染临床研究[J].中国感染控制杂志,2016,15(6):384-387,392.
[7]曹海华,刘春燕,张赛,等.低温疗法联合人工脑脊液置换治疗颅内感染的安全性和有效性[J].中华危重病急救医学,2016,28(4):369-370.
[8]贾锋,阮舒,伏林山.鞘内注射万古霉素治疗神经外科术后颅内感染患者的疗效观察[J].中华医院感染学杂志,2013,23(22):5525-5526,5529.
[9]陈凯,王佳庆,武元星,等.脑室内注射万古霉素治疗术后颅内感染的方法学及药代动力学研究[J].临床神经外科杂志,2014,11(6):435-439.
[10]肖二辉,李治晓,康谊,等.腰大池引流与万古霉素鞘内疗法在颅脑外伤术后颅内感染治疗中的应用[J].中国实用神经疾病杂志,2016,19(14):125-126.
[11]王森岗,赵建奇,敬谢攀,等.万古霉素鞘内注射与腰大池引流对高血压脑出血患者术后颅内感染治疗分析[J].中华医院感染学杂志,2015,25(9):1999-2001.
[12]邹积典,郭庆雷,侯英芳,等.万古霉素治疗术后耐甲氧西林革兰阳性菌致颅内感染的疗效[J].中华医院感染学杂志,2013,23(12):2983-2985.
[13]单小松,丁亚楠,王冀伟,等.开颅手术后颅内感染患者脑脊液置换联合不同药物鞘内注射治疗的疗效研究[J].中华医院感染学杂志,2015,25(12):2802-2804.
[14]李奕锋,闫世军,韩越杨,等.腰穿与腰大池引流结合鞘内注射万古霉素治疗高血压性脑出血开颅术后颅内感染的临床疗效[J].中国老年学杂志,2015,35(5):1300-1301.
[15]彭宪星,刘芹.腰穿与腰大池引流结合鞘内注射万古霉素治疗高血压脑出血开颅术后颅内感染的疗效[J].中国实用神经疾病杂志,2016,19(10):116-117.