脑脊液置换配合鞘内注药治疗结核性脑膜炎的效果观察

The efficacy of cerebrospinal fluid replacement combined with intrathecal injections in treatment of tubercular meningitis

目的探讨脑脊液置换配合鞘膜腔内注药(简称鞘内注药)治疗结核性脑膜炎的临床效果。方法将82例结核性脑膜炎患者随机分为两组,两组均予常规治疗,在此基础上治疗组加用脑脊液置换配合鞘内注药治疗。比较两组间的临床疗效。结果治疗组主要各项生化指标均比治疗前明显改善(P均<0.01)。脑脊液恢复正常时间、症状体征消失时间以及住院时间比对照组明显缩短(P均<0.01);脑积水均消除,后遗局灶神经异常亦显著低于对照组(P<0.05或0.01);总有效率(100.00%)明显高于对照组(78.57%),χ2=7.56,P<0.01。两组均未出现并发症及明显副作用。结论脑脊液置换配合鞘膜腔内注药治疗结核性脑膜炎能缓解临床症状、体征,降低病死率。

Objective To investigate the efficacy of cerebrospinal fluid replacement combined with intrathecal injections in treatment of tubercular meningitis. Methods Eighty-two patients with tubercular meningitis were randomly divided into two groups, the therapeutic group and the control group. The two groups were all given traditional treatment, then the therapeutic group received additional treatment with cerebrospinal fluid replacement plus intrathecal injections. A comparative study of the efficacy between these two groups had been done. Results In the therapeutic group, every biochemical indexes after treatment improved significantly, in comparison to those pre-treatment, there were statistically significant differences (all P<0.01). The cerebrospinal fluid recovery time, signs and symptoms disappearance time and the in-hospital time were shorter than those in the control group (all P<0.01); all the hydrocrania was eliminated. The incidence of nervous disease occurred in the sequel focals were significantly lower than those in the control group (P<0.05 or 0.01); the total effective rate (100.00%) was higher than that in the control group (78.57%), χ2=7.56, P<0.01. No complication and side effect occurred in these two groups. Conclusion Cerebrospinal fluid replacement combined with intrathecal injections in treatment of tubercular meningitis can remit clinical symptoms and signs, and can reduce the fatality rate.