持续腰大池引流联合美罗培南鞘内注射治疗高血压脑出血术后颅内感染的疗效分析

Clinical effect of continuous lumbar drainage combined with intrathecal injection of meropenem on treatment of hypertensive cerebral hemorrhage patients with postoperative intracranial infections

目的探讨持续腰大池引流联合美罗培南鞘内注射治疗高血压脑出血术后颅内感染患者的临床效果,为临床治疗提供参考依据。方法以2010年1月-2015年1月于医院行手术治疗后发生颅内感染的60例高血压脑出血患者为研究对象,根据治疗方法的不同分为对照组与观察组,各30例,对照组单独给予美罗培南鞘内注射治疗,观察组在对照组用药基础上实施持续腰大池引流治疗,比较两组患者临床治疗的疗效,数据采用SPSS17.0软件进行统计分析。结果两组患者治疗后脑脊液中白细胞与蛋白浓度均降低,葡萄糖浓度升高,细菌培养阳性患者减少,各项指标观察组改善程度优于对照组,差异均有统计学意义(P<0.05);观察组治疗总有效率为90.00%,明显高于对照组的70.00%,差异有统计学意义(P<0.05)。结论在高血压脑出血术后颅内感染的治疗中,给予患者美罗培南鞘内注射治疗的同时,实施持续腰大池引流治疗可显著提高治疗效果,值得临床应用。

OBJECTIVE To explore the clinical effect of continuous lumbar drainage combined with intrathecal injection of meropenem on treatment of hypertensive cerebral hemorrhage patients with postoperative intracranial infections so as to provide guidance for clinical treatment.METHODS A total of 60 hypertensive cerebral hemorrhage patients with postoperative intracranial infections who were treated in hospitals from Jan 2010 to Jan 2015 were recruited as the study objects and divided into the control group and the observation group according to the treatment method,with 30 cases in each.The control group was treated with single intrathecal injection of meropenem,while the observation group was given additional continuous lumbar drainage based on the treatment of the control group.The clinical therapeutic effects were observed and compared between the two groups of patients,and the statistical analysis of data was performed with the use of SPSS 17.0software.RESULTS The white blood cell counts and protein concentration in cerebrospinal fluid were reduced in the two groups of patients after the treatment,the glucose concentration was elevated,and the number of the patients who were positive for bacterial culture was decreased.The improvement degree of indicators of the observation group was better than that of the control group,and there was significant difference（P〈0.05）.The total effective rate of treatment of the observation group was 90.00%,significantly higher than 70.00% of the control group（P〈0.05）.CONCLUSIONThe continuous lumbar drainage combined with intrathecal injection of meropenem can achieve significant clinical effect on treatment of the hypertensive cerebral hemorrhage patients with postoperative intracranial infections,and it is worthy to be promoted in the hospital.