脑脊液置换加鞘内注药治疗结核性脑膜炎及结核性脑膜脑炎疗效研究

Observation on Efficacy of Cerebrospinal Fluid Replacement Combined with Intrathecal Injection on Treating Tuberculous Meningitis and tuberculous meningoencephalitis

目的探讨脑脊液置换加鞘内注药治疗结核性脑膜炎和结核性脑膜脑炎(二者统称结脑)的临床疗效。方法将确诊的63例结脑患者随机分两组。对照组予以常规抗结核药物及激素等治疗。治疗组在此基础上采用脑脊液置换加鞘内注药治疗。观察两组患者的体温、颅压、临床体征、颅内病灶吸收情况和脑脊液(CSF)等变化,并进行比较。结果治疗组患者体温、颅压降至正常,意识恢复时间及CSF中细胞数、糖、蛋白质、氯化物等恢复时间均短于对照组(P<0.05);治疗1个月后,患者颅内病灶吸收情况及并发症改善优于对照组(P<0.05)。结论脑脊液置换加鞘内注药可缓解结脑的症状,缩短疗程,减少并发症,该方法是治疗结核性脑膜炎的一种简单、有效、安全的方法。

Objective To investigate the clinical effect of cerebrospinal fluid（CSF）replacement combined with intrathecal injection on treating tuberculous meningitis and tuberculous meningoencephalitis.Methods A total of 63 patients with tuberculous meniingitis and tuberculous meningoencephalitis were randomly divided into two groups.All patients were treated with antituberculous drugs and prednisone.In addition,the patients in the treatment group received Cerebrospinal Fluid Replacement Combined with Intrathecal Injection as an adjuvant therapy.The body temperature,intracranial pressure,clinical symptom and signs,the absorption of the intracranial focus and the variation of Cerebrospinal Fluid（CSF）examination were observed and compared between the two groups.Results Body temperature,intracranial pressure,consciousness and CSF examination findings（protein,chloride,glucose concentration,etc）returned to normal faster in the treatment group（P0.05）.After one month of treatment,the improvement in the absorption of the intracranial focus and complication was superior to that in the control group（P0.05）.Conclusion CSF replacement combined with intrathecal injection can relieve tuberculous meningitis＇ symptoms,and it is a simple,effective and secure method.