持续腰大池引流联合鞘内注射庆大霉素对脑室出血术后颅内感染的临床效果分析

Clinical effect analysis of continuous lumbar cistern drainage combined with intrathecal injection of gentamicin on intracranial infection after ventricular hemorrhage

目的分析持续腰大池引流联合鞘内注射庆大霉素对脑室出血术后颅内感染的临床效果。方法回顾性分析安徽医科大学第一附属医院神经外科自2018年1月至2020年12月收治的80例脑室钻孔引流术后颅内感染患者的临床资料,按照治疗方式不同将患者分为观察组(40例)和对照组(40例),2组患者均给予美罗培南(2 g q8h)+万古霉素(1 g q12h)静脉滴注,对照组行腰椎穿刺后注入庆大霉素,观察组行鞘内注射庆大霉素并持续腰大池引流。比较2组患者治疗1周以后的脑脊液相关指标(常规、生化)好转程度。结果观察组有效率(92.50%)明显高于对照组(70.00%),白细胞计数、脑脊液蛋白质、葡萄糖及氯好转程度均优于对照组,差异有统计学意义(P<0.05)。结论持续腰大池引流联合鞘内注射庆大霉素对脑室出血钻孔引流术后颅内感染的治疗有显著效果,可明显缩短治疗时间,取得很好的临床效果。

Objective To investigate the clinical effect of continuous lumbar cisternal drainage combined with intrathecal injection of gentamycin on intracranial infection after ventricular hemorrhage.Methods Eighty cases of patients with intracranial infection after ventricle borehole drainage in Department of Neurosurgery,The First Affiliated Hospital of Anhui Medical University from January 2018 and December 2020 were retrospectively analyzed.According to random number table method,the patients were randomly divided into observation group(40 cases)and the control group(40 cases),two groups were given meropenem q8h(2 g)+vancomycin q12h(1 g)intravenous drip,the control group received gentamicin injection after lumbar puncture,and the observation group received intrathecal gentamicin injection and continuous lumbar cistern drainage.The improvement degree of cerebrospinal fluid related indexes(routine and biochemical)of the two groups after 1 week of treatment were compared.Results The effective rate of the observation group(92.50%)was significantly higher than that of the control group(70.00%),the improvement of white blood cell count,cerebrospinal fluid protein,glucose and chlorine were better than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Continuous lumbar cisternal drainage combined with intrathecal injection of gentamicin has a significant effect on the treatment of intracranial infection after ventricular hemorrhage borehole drainage,which can significantly shorten the treatment time and achieve a good clinical effect.