脑脊液负流量置换加鞘内注药治疗结核性脑膜炎92例

Replacement of cerebrospinal fluid with negative flow and intrathecal injection to treat tuberculous meningitis for 92 cases

目的探讨脑脊液负流量置换加鞘内注药治疗结核性脑膜炎的临床疗效。方法92例结核性脑膜炎患者分为观察组(47例)和对照组(45例),所有患者均采用4HRZE(S)/4HRZE/4HRE方案抗结核治疗,观察组患者在此基础上同时采用脑脊液负流量置换加鞘内注药,然后进行疗效对比。结果治疗2周和8周时2组脑脊液蛋白、白细胞数和脑脊液压力下降的速度比较差异有统计学意义(P<0.01)。治疗8周时观察组总有效率为87.23%,对照组总有效率为60.00%,2组总有效率比较差异有统计学意义(P<0.01)。未发现与脑脊液负流量置换加鞘内注药相关的并发症。结论脑脊液负流量置换加鞘内注药治疗结核性脑膜炎可提高疗效,是一种简单、有效、安全的方法,值得在临床上推广使用。

Objective To explore the curative effect of replacement of cerebrospinal fluid with negative flow and intrathecal injection on the tuberculosis cephalomeningitis. Methods Ninty-two cases with tuberculosis meningitis were randomly divided into observation group（47 cases） and control group（45 cases）. Both groups were given the therapy of 4HRZE （S） /4HRZE/4HRE,while the treatment group were also treated by replacement of cerebrospinal fluid with negative flow and intrathecal injection, then comparision were made between two groups. Results After treatment for 2 weeks and 8 weeks, there were significant difference between the two groups in the reduction rate of protein, leukocyte and the pressure of cerebrospinal fluid（P 〈0.01 ）. To treat 8 weeks later,the total effective rate was 87.23% in the observation group,and that was 60.00% in the control group, there was significant difference between the two groups （ P 〈 0.01 ）. No complications and obvious adverse reactions were observed during the treatment. Conclusion The treatment of replacement of cerebrospinal fluid with negative flow and intrathccal injection can improve fhc effect for treating tuberculous meningitis. It is a simple, effective and safc method that is worth to be used in clinic.