腰大池持续引流联合抗菌药物治疗患者术后颅内感染的疗效分析

Efficacy of continuous lumbar drainage combined with antibiotic therapy for treatment of postoperative intracranial infections

目的探讨腰大池持续引流联合静脉及鞘内抗菌药物治疗神经外科患者术后颅内感染的临床疗效。方法回顾性分析2014年2月-2015年2月68例行神经外科手术患者临床资料,根据治疗方式分为研究组和对照组,每组各34例,对照组给予静脉、鞘内抗菌药物治疗,研究组在对照组的基础上联合腰大池持续引流治疗;分析两组患者术后颅内感染的发生率。结果研究组患者的治疗有效率94.12%,显著高于对照组的73.53%,差异有统计学意义(χ2=5.31,P<0.05);治疗后研究组患者脑脊液蛋白质、白细胞含量显著低于对照组,葡萄糖含量显著高于对照组,差异有统计学意义(t=4.735、12.136、4.28,P<0.05);治疗后研究组患者颅内压的数值显著低于对照组,差异有统计学意义(t=4.647,P<0.05);研究组患者术后颅内感染发生率8.82%,显著低于对照组的32.35%,差异有统计学意义(χ2=5.76,P<0.05)。结论腰大池持续引流联合静脉、鞘内给予抗菌药物治疗神经外科患者术后颅内感染,可有效提高治疗的有效率,促进脑脊液中指标的恢复,预防术后颅内感染的发生。

OBJECTIVE To explore the clinical efficacy of continuous lumbar drainage combined with antibiotic therapy for treatment of postoperative intracranial infections.METHODS Clinical data of 68 neurosurgical patients from Feb.2014 to Feb.2015 were retrospectively analyzed.The patients were divided to the study group and the control group according to treatments,each group of 34 patients.The control group was given intravenous and intrathecal antibiotic medication,the treatment in the study group was combined with lumbar cistern continuous drainage on the basis of medication in the control group.The postoperative intracranial infection was analyzed.RESULTS Treatment efficiency was 94.12%for the study group,significantly higher than 73.53%for the control group（χ2= 5.31,P 0.05）.After treatment,proteins and white blood cells were lower and glucose was significantly higher for the study group than for the control group（t = 4.735,12.136,4.28,P 0.05）.The intracranial pressure value was significantly lower for the study group compared to the control group（t= 4.647,P〈0.05）.The incidence of intracranial infection was 8.82%for the study group,significantly lower than 32.35%for the control group（χ2= 5.76,P 0.05）.CONCLUSIONContinuous lumbar drainage combined with intravenous and intrathecal antibiotic therapy for treatment of postoperative intracranial infection can effectively improve the efficiency of treatment,promote the recovery of cerebrospinal fluid indicators and prevent postoperative intracranial infections.