脑脊液置换联合鞘内给药治疗结核性脑膜炎临床分析

Efficacy of exchange with intrathecal administration of drugs in treatment of tuberculosis meningitis

目的探讨脑脊液置换加鞘内给药在结核性脑膜炎中的应用。方法选择2003年2月至2008年5月结核性脑膜炎75例,分为治疗组和对照组。对照组常规治疗,治疗组在常规治疗的基础上采用脑脊液置换联合鞘内注药,2个月后对两组疗效进行比较分析。结果采用脑脊液置换加鞘内给药后,治疗组患者临床症状明显缓解,症状期明显缩短。脑脊液生化指标均优于对照组(P<0.01),治疗组总有效率为95.0%,治愈率为60.0%,对照组总有效率为71.4%,治愈率为34.3%,经统计学处理有极显著性意义(P<0.01)。结论脑脊液置换加鞘内给药,对减少蛛网膜粘连、椎管梗阻及脑积水有较好的效果,是治疗结核性脑膜炎的有效方法之一。

Objective To observe the effectiveness of cerebrospinal fluid replacement combining in- trathecal drug therapy in patients with cerebral tuberculosis. Methods 75 patients were randomly assigned into threatment and control groups. On the basis of conventional intrathecal drug therapy, the treatment group re- ceived additional CSF exchange. The effective and cure rates of both groups were compared at the end of the 2th month. Results The treatment group outstripped the control group in improvement of CSF biochemical indicator ADA （P 〈 O. 05 ）, the total effective rate was 95.0% and cure rate was 60. 0%, versus only71.4% and 34. 3 % in the control group（ P 〈 0. O1 ）. Conclusion Cerebrospinal fluid exchange combined intrathecal drug therapy has marked curative effect in curing cerebral tuberculsis.