利奈唑胺治疗神经外科术后颅内感染的疗效及安全性分析

Analysis of Clinical Efficacy and Safety of Linezolid in the Treatment of Intracranial Infection after Neurosurgery Operation

目的:探讨利奈唑胺用于神经外科术后颅内感染的疗效及安全性。方法:回顾性分析2015年7月1日-2016年8月29日在空军军医大学西京医院因神经外科术后颅内感染使用利奈唑胺治疗的39例患者的病历资料,根据利奈唑胺治疗前后患者的症状、体征、实验室检查及细菌培养结果等指标,评价利奈唑胺治疗神经外科术后颅内感染的有效性及安全性。结果:39例神经外科术后发生颅内感染的患者使用利奈唑胺治疗后,总有效率为79.49%。治疗后,患者的体温、白细胞、中性粒细胞绝对值、脑脊液白细胞及脑脊液蛋白质水平均较治疗前显著降低,差异均有统计学意义(P<0.05)。39例患者中,有27例在治疗前进行了脑脊液培养,且8例(29.6%)结果呈阳性,其中6例(75.0%)培养出葡萄球菌、肠球菌等革兰氏阳性菌。所有患者均未见明显的利奈唑胺相关不良反应发生。结论:利奈唑胺可有效控制葡萄球菌属、肠球菌属等革兰氏阳性菌引起的神经外科术后颅内感染,且安全性较高。

OBJECTIVE：To investigate clinical efficacy and safety of linezolid in the treatment of intracranial infection after neurosurgery operation. METHODS：Medical information of 39 intracranial infection patients receiving linezolid in Xijing Hospital of Air Force Medical University during Jul. 1 st,2015-Aug. 29 th,2016 were analyzed retrospectively. The clinical efficacy and safety of linezolid in the treatment of intracranial infection after neurosurgery operation were evaluated according to indexes of intracranial infection patient,such as symptoms,signs,lab indexes test and bacterial culture results. RESULTS：Total response rate of 39 intracranial infection patients after neurosurgery operation was 79.49% after linezolid treatment. After treatment,the patients＇ body temperature,white blood cell,neutrophil absolute value,white blood cell in cerebrospinal fluid and cerebrospinal fluid protein level were all significantly lower than before treatment,with statistical significance（P〈0.05）. Of 39 patients,cerebrospinal fluid of 27 patients were cultured before treatment,and 8 cases（29.6%）of which were positive,among which there were 6 cases（75.0%）of Gram-positive bacteria such as Staphylococcus and Enterococcus. No obvious ADR related to linezolid was found in patients. CONCLUSIONS：Linezolid can effectively control the intracranial infection caused by Gram-positive bacteria such as Staphylococcus and Enterococcus with good safety.