【摘要】：目的:觀察美羅培南聯(lián)合萬古霉素鞘內(nèi)注射治療開顱術(shù)后顱內(nèi)感染的臨床療效及安全性。方法:采用回顧性分析方法,選擇我院2014年5月-2016年6月開顱術(shù)后顱內(nèi)感染患者46例,按照治療方法分為對照組(20例)和觀察組(26例)。對照組患者給予注射用鹽酸萬古霉素1.0 g,ivgtt,bid+注射用美羅培南2.0 g,ivgtt,tid;觀察組患者行腰大池置管引流釋放腦脊液后,緩慢給予注射用鹽酸萬古霉素20 mg,用0.9%氯化鈉注射液2 mL沖管后,緩慢給予注射用美羅培南20 mg,bid。兩組患者均治療2周。觀察兩組患者腦脊液細菌培養(yǎng)情況、臨床療效、治愈時間及其治療費用,并記錄不良反應(yīng)和治療后6個月的后遺癥發(fā)生情況。結(jié)果:46例患者腦脊液細菌培養(yǎng)陽性率為45.7%。觀察組患者痊愈率(92.3%)顯著高于對照組(65.0%),治愈時間及其治療費用均顯著短/低于對照組;總不良反應(yīng)發(fā)生率(7.7%)顯著低于對照組(40.0%),后遺癥發(fā)生率(3.8%)顯著低于對照組(20.0%),差異均有統(tǒng)計學意義(P0.05)。結(jié)論:美羅培南聯(lián)合萬古霉素鞘內(nèi)注射治療開顱術(shù)后顱內(nèi)感染的療效優(yōu)于靜脈給藥,可顯著縮短治療時間,降低治療費用,且安全性較好。
[Abstract]:Objective: to observe the clinical efficacy and safety of meropenem combined with vancomycin intrathecal injection in the treatment of intracranial infection after craniotomy. Methods: 46 patients with intracranial infection after craniotomy in our hospital from May 2014 to June 2016 were selected and divided into control group (n = 20) and observation group (n = 26) according to the treatment method. The patients in the control group were given vancomycin hydrochloric acid 1.0 g, ivgtt, bid for meropenem 2.0 g, ivgtt, tid. after drainage and release of cerebrospinal fluid in the lumbar cistern, the patients in the observation group were slowly given vancomycin hydrochloric acid 20 mg, with 0.9% sodium chloride injection 2 mL, and meropenem 20 mg,bid. for injection Both groups were treated for 2 weeks. The bacterial culture, clinical curative effect, cure time and treatment cost of cerebrospinal fluid in the two groups were observed, and the adverse reactions and sequelae 6 months after treatment were recorded. Results: the positive rate of bacterial culture in cerebrospinal fluid of 46 patients was 45.7%. The cure rate (92.3%) in the observation group was significantly higher than that in the control group (65.0%), the cure time and treatment cost were significantly shorter / lower than those in the control group, the total incidence of adverse reactions (7.7%) was significantly lower than that in the control group (40.0%), and the incidence of sequelae (3.8%) was significantly lower than that in the control group (20.0%). Conclusion: the efficacy of meropenem combined with vancomycin intrathecal injection in the treatment of intracranial infection after craniotomy is better than that of intravenous administration, which can significantly shorten the treatment time, reduce the cost of treatment, and is safe.
【作者單位】： 民航總醫(yī)院重癥醫(yī)學科;
【分類號】：R651.1

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