万古霉素脑脊液置换及鞘内应用治疗重症颅内化脓性感染

Application of cerebrospinal fluid replacement and intrathecal injection with vancomycin to severe intracranial suppurative infection

目的:探讨万古霉素溶液行脑脊液置换及鞘内应用治疗化脓性脑膜炎的临床疗效。方法:对23例经静脉抗炎治疗无效的重症颅内化脓性感染患者予万古霉素溶液行脑脊液置换及鞘内注入,脑脊液置换万古霉素浓度为0.05%,鞘内应用万古霉素50mg/次,1～2次/d,同时予地塞米松2.5～5.0mg鞘内注入。结果:经治疗的23例颅内化脓性感染中21例治愈,2例无效,治愈率91.3%,无效的2例经改用美罗培南和丁胺卡那治疗后感染控制。在应用万古霉素治疗过程中未见任何毒副作用。结论:万古霉素溶液行脑脊液置换及鞘内应用治疗重症颅内化脓性感染简单、安全,且疗效显著。

Objective： To investigate the clinical efficacy of cerebrospinal fluid replacement and intrathecal injection with vancomycin on severe intracranial suppurative infection. Methods： 23 cases of severe suppurative meningitis were treated with vancomycin cerebrospinal fluid replacement and vancomycin intrathecal injection,with the concentration of 0.05 percent vancomycin for cerebrospinal fluid replacement and the weight of 50 mg vancomycin for intrathecal injection each time, 1 to 2 times a day; at the same time,patients were injected with dexamethasone 2.5 to 5.0 mg for intrathecal injection together. Results： 21 of the 23 cases in our study were cured but 2 cases were ineffective,with an effective rate of 91.3%. The infection of two ineffective cases were controlled when switching to the treatment of meropenem and amikacin. Conclusion： The clinical efficacy of cerebrospinal fluid replacement and intrathecal injection for severe intracranial suppurative infection with vancomycin solution is significant and the method also very simple and safe.