持续腰大池引流治疗高血压脑出血患者术后颅内感染的临床研究

Clinical effect of continuous lumbar drainage on treatment of hypertensive cerebral hemorrhage patients complicated with postoperative intracranial infections

目的：探讨美罗培南鞘内注射与持续腰大池引流治疗高血压脑出血患者术后颅内感染的效果，为临床治疗提供新思路和方法。方法选择医院66例高血压脑出血术后发生颅内感染患者，将其随机分为观察组和对照组，每组各33例，两组均采用美罗培南鞘内注射治疗，观察组在此基础上采用持续腰大池引流，引流时间1～2周，比较两组患者的脑脊液检查结果和临床主要指标及临床疗效。结果两组患者治疗后脑脊液检查结果和其他临床主要指标等方面均较治疗前明显改善，观察组与对照组比较改善更明显，差异均有统计学意义（P＜0．05）；临床治疗总有效率观察组为90．91％、对照组为72．73％，两组比较差异有统计学意义（ P＜0．05）。结论腰大池持续引流结合美罗培南鞘内注射治疗高血压脑出血术后颅内感染效果明显，值得临床推广。

OBJECTIVE To explore the effect of intrathecal injection of meropenem combined with continuous lum-bar drainage on treatment of hypertensive cerebral hemorrhage patients complicated with postoperative intracranial infections so as to provide a new approach for clinical treatment .METHODS A total of 66 hypertensive cerebral hemorrhage patients complicated with postoperative intracranial infections were enrolled in the study and randomly divided into the observation group and the control group ,with 33 cases in each ;both groups were treated with in-trathecal injection of meropenem ,the observation group was given additional continuous lumbar drainage for 1-2 weeks ,and the results of examination of cerebral spinal fluids ,major clinical indicators ,and clinical efficacy were observed and compared between the two groups .RESULTS The results of examination of cerebral spinal fluids and the major clinical indicators were significantly improved after the treatment ,which were improved more signifi-cantly in the observation group than in the control group（P〈0 .05） .The total effective rate of clinical treatment was 90 .91% in the observation group ,72 .73% in the control group ,and there were significant difference between the two groups （P〈0 .05） .CONCLUSION The continuous lumbar drainage combined with intrathecal injection of meropenem can achieve significant effect on treatment of the hypertensive cerebral hemorrhage patients complicated with postoperative intracranial infections ,and it is worthy to be promoted in the hospital .