脑脊液置换联合鞘内注药治疗结核性脑膜炎的临床疗效观察

Clinical observation of cerebrospinal fluid replacement combined with intrathecal injections in treatment of tuberculous meningitis

目的探讨脑髓液置换联合鞘内注药治疗结核性脑膜炎的临床疗效。方法选择2008年9月-2010年9月,收治的结核性脑膜炎患者86例,随机将患者分为观察组和对照组,每组43例,2组患者均给予抗结核和保肝以及激素和脱水剂等常规药物治疗,观察组在此基础上加用脑脊液置换与鞘内给药的联合治疗,对2组患者的临床疗效等相关指标进行比较分析。结果与对照组相比,观察组的治愈率和总有效率均显著提高,分别高达72.09%和90.70%;而无效率则显著降低,仅为9.30%,差异均有统计学意义(P<0.05);与此同时,观察组的发热、头痛、脑膜刺激征消失时间;压力、脑脊液细胞和脑脊液蛋白恢复时间;住院时间均显著降低,差异均有统计学意义(P<0.05)。结论脑髓液置换联合鞘内注药治疗结核性脑膜炎,其疗效确切,效果显著,是结核性脑膜炎患者较为理想的综合治疗方法,值得临床推广和应用。

OBJECTIVE To probe into the clinical effect of cerebrospinal fluid replacement combined with intrathecal injections in treatment of tuberculous meningitis. METHODS The 86 patients with tuberculous meningitis selected from Sep 2008 to Sep 2010 were randomly divided into two groups and the control group of 43 cases. After two groups of patients were given anti-TB diagnosis and liver after hormone and dehydration agents, and conventional drug therapy, and observation of patients in which cerebrospinal fluid replacement based on the use of combination therapy with intrathecal administration, and the clinical efficacy of the two groups was performed comparative analysis of relevant indicators. RESULTS Compared with control group, the patients of the cure rate and total effective rate was significantly increased as high as 72. 09% and 90. 70O/o; without significantly reducing the efficiency of only 9.30 ~/0, there were significant differences （P〈0.05）. At the same time, compared with control group, observe the disappearance time of fever patients, headache disappearance time, disappearance time of meningeal irritation, pressure recovery time, recovery time of cerebrospinal fluid cells, cerebrospinal fluid recovery time and hospital stay were significantly lower, there were also significant differences （P〈0. 05）. CONCLUSION The efficacy of cerebrospinal fluid replacement combined with intrathecal injections in treatment of tuberculous meningitis is accurate and significant and is an ideal comprehensive therapy for tuberculous meningitis patients and worthy of further clinical promotion and application.