鞘内注射抗生素在颅脑损伤后颅内感染患者中的应用价值

Value of intrathecal injection of antibiotics in treatment of patients with intracranial infection after traumatic brain injury

目的探讨鞘内注射抗生素对颅脑损伤后颅内感染的预防作用。方法将260例颅脑损伤后颅内感染患者随机分为对照组和观察组。对照组鞘内给予生理盐水6 m L置换脑脊液;观察组鞘内给予头孢他啶0.08 g,溶于6 m L生理盐水中置换脑脊液。比较2组临床转归及治疗前后脑脊液、血液中疾病相关因子水平。结果观察组颅内感染发生率为9.23%,显著低于对照组的31.54%(P<0.05)。治疗后1、3 d,观察组患者脑脊液中PCT水平、WBC计数显著低于对照组,而氯化物和葡萄糖水平则显著高于对照组(P<0.05);观察组患者血清中PCT、TNF-α、IL-1β、IL-6和hs-CRP水平显著低于对照组(P<0.05)。结论鞘内注射抗生素能有效抑制颅脑损伤患者的炎症状态,降低颅内感染的发生率。

Objective To explore the effect of intrathecal injection of antibiotics on the prevention of intracranial infection after craniocerebral injury. Methods A total of 260 patients with intracranial infection after brain injury were randomly divided into control group and observation group.The control group was given normal saline 6 m L to replace cerebrospinal fluid,while the observation group was given intrathecal ceftazidime 0. 08 g in 6 m L saline solution to replace cerebrospinal fluid.Clinical outcomes and the disease-related factors in CSF and blood were compared. Results The incidence rate of intracranial infection in the observation group was 9. 23%,which was significantly lower than 31. 54% in the control group（ P〈0. 05）. One and three days after treatment,the levels of PCT and WBC in cerebrospinal fluid of the observation group were significantly lower than those of the control group,while the levels of chloride and glucose were significantly higher than those of the control group（ P〈0. 05）. The serum levels of PCT,TNF-α,IL-1β,IL-6 and hs-CRP in the observation group were significantly lower than those in the control group（ P〈0. 05）. Conclusion Intrathecal injection of antibiotics can effectively inhibit the inflammatory state of patients with brain injury and reduce the incidence rate of intracranial infection.