鞘内注射万古霉素治疗颅内感染疗效及安全性研究

Efficacy and safety of intrathecal injection of vancomycin in treatment of intracranial infection

目的:探讨颅内感染患者鞘内注射万古霉素治疗的疗效。方法:选取因重型颅脑损伤所致颅内感染患者81例,按照随机数字表法分成观察组41例与对照组40例,两组均使用万古霉素治疗,对照组采取静脉滴注的用药方式,观察组采取鞘内注射的用药方式,比较两组患者症状缓解时间、治疗效果、治疗前后白细胞计数与白蛋白水平、治疗期间不良反应情况。结果:观察组患者在体温恢复正常时间、头痛消失时间、脑脊液白蛋白恢复正常时间、住院时间上均比对照组短(P<0.05);观察组治疗总有效率95.12%与对照组92.50%比较差异无统计学意义(P>0.05);治疗后两组脑脊液白蛋白与血清白细胞计数水平均较治疗前降低,但两组治疗前后各项指标比较差异无统计学意义(P>0.05)观察组治疗期间不良反应总发生率4.88%显著低于对照组22.50%(P<0.05)。结论:对颅内感染的患者,应用鞘内注射万古霉素的治疗方式,可促进患者感染症状的缓解,缩短住院时间及降低不良反应发生率。

Objective:To explore the efficacy of intrathecal injection of vancomycin in the treatment of patients with intracranial infection.Methods:81 patients with intracranial infection caused by severe craniocerebral injury were randomly divided into observation group(41 cases) and control group(40 cases).The observation group was treated with intrathecal injection.The symptom relief time,treatment effect,white blood cell count and albumin level before and after treatment,and adverse reactions during treatment were compared between the two groups.Results:The observation group was shorter than the control group in terms of body temperature return to normal time,headache disappearance time,cerebrospinal fluid albumin return to normal time,and hospitalization time(P<0.05).The total effective rate of the observation group was 95.12%,and the control group was 92.50%,the difference was not statistically significant(P>0.05).After treatment,the cerebrospinal fluid albumin and serum white blood cell counts of the two groups were lower than those before treatment,but there was no statistically significant difference between the two groups before and after treatment(P>0.05).The total incidence of adverse reactions during treatment in the observation group was 4.88%,which was significantly lower than 22.50% in the control group(P<0.05).Conclusion:For patients with intracranial infection,the application of intrathecal injection of antibacterial drugs can promote the alleviation of infection symptoms,shorten the treatment time and reduce the incidence of adverse reactions.