万古霉素与地塞米松联合鞘内注射治疗颅内化脓性感染

Clinical efficiency of vancomycin combined with dexamethasone intrathecal injection for the treatment of intracranial pyogenic infection

目的:探讨应用脑脊液置换加万古霉素和地塞米松联合鞘内注射对颅内化脓性感染的治疗作用。方法:回顾对比2组颅内化脓性感染患者,在静脉应用透过血脑屏障抗菌药物(头孢曲松)的同时,分别给予单纯脑脊液置换治疗、脑脊液置换加万古霉素和地塞米松联合鞘内注射治疗。观察对比2组病例在治疗前、后患者体温、脑脊液常规、生化指标、脑脊液细菌培养的情况及其治愈率、治愈时间的情况。结果:2组比较,在14d治愈率、20d治愈率、总治愈率及治愈时间方面,鞘内联合注药组明显优于对照组,差异具有统计学意义(P<0.05)。在神经根刺激症状等并发症方面,鞘内注药组与对照组无统计学差异(P>0.05)。结论::脑脊液置换加万古霉素和地塞米松联合鞘内注射治疗颅内化脓性感染疗效显著,实用安全。

OBJECTIVE To evaluate the efficiency of treatment that using the CSF（cerebrospinal fluid） replacement plus vancomycin combined with dexamethasone intrathecal injection to cure intracranial pyogenic infection. METHODS Reviewed the two groups of intracranial purulent infection, we injected antibiotics （third-generation cephalosporin） which can pass the blood-brain barrier by intravenous injection,at the same time, one group was simple given a replacement of cerebrospinal fluid, the other was given cerebrospinal fluid replacement plus vancomycin combined with dexamethasone intrathecal injection. Com pared the two groups＇ treatment efficiency by observing the body temperature, CSF general checking, biochemical indicators, CSF bacterial culture and its curing rate, curing time. RESULTS After comparing the two groups, in the 14-day.20 -day curing rate, the total curing rate and time, intrathecal injection＇s group was significantly superior to the control group, the difference was significant （P〈0. 05）. In the aspect of nerve root irritation symptom and other complications, it had no statistical difference between the intrathecal injection group and the control group （P〉0. 05）. CONCLUSION By the cerebrospinal fluid replacement plus vancomycin combined with dexamethasone intrathecal injection, the therapy is proved practically and safely to treat the intracranial pyogenic infection.