腰大池持续引流联合抗菌药治疗颅脑术后颅内感染的临床观察

Clinical Observation of Continuous Lumbar Cistern Drainage Combined with Antibiotics in the Treatment of Intracranial Infection after Craniocerebral Operation

目的:观察腰大池持续引流联合抗菌药治疗颅脑术后颅内感染的临床效果。方法:选取2016年1月~2019年9月在某院治疗的颅脑术后颅内感染患者64例,采用简单抽样法将其分为对照组和观察组各32例,对照组给予美罗培南、万古霉素静脉滴注治疗,观察组给予腰大池持续引流联合美罗培南、万古霉素治疗,比较两组治疗疗效及治疗期间不良反应发生率,比较两组治疗前后临床指标(脑脊液白细胞计数、蛋白质浓度)及炎症因子水平(超敏C反应蛋白(hs-CRP)、降钙素原(PCT)),比较两组临床症状改善时间及感染控制时间。结果:观察组治疗总有效率高于对照组(P<0.05);观察组临床症状改善时间及感染控制时间短于对照组(P<0.05);观察组白细胞计数少于对照组,蛋白质浓度、hs-CRP、PCT低于对照组(P<0.05)。结论:腰大池持续引流联合抗菌药治疗颅内感染有效率高,能减轻患者炎症反应,缩短临床症状改善时间。

Objective:To observe the clinical effect of continuous lumbar cistern drainage combined with antibiotics in the treatment of intracranial infection after craniocerebral surgery.Methods:64 patients with intracranial infection after craniocerebral surgery in a hospital from January 2016 to September 2019 were selected and divided into control group and observation group by simple sampling method,with 32 cases in each group.The control group was treated with intravenous drip of meropenem and vancomycin,and the observation group was treated with continuous lumbar cistern drainage combined with meropenem and vancomycin.The curative effect and the incidence of adverse reactions were compared between the two groups;The clinical indexes(cerebrospinal fluid leukocyte count,protein concentration)and inflammatory factors(high sensitivity C-reactive protein(hs CRP),procalcitonin(PCT))were compared between the two groups before and after treatment;The improvement time of clinical symptoms and infection control time were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).The improvement time of clinical symptoms and infection control time in the observation group were shorter than those in the control group(P<0.05).The white blood cell count,protein concentration,hs-CRP and PCT of the observation group were lower than those of the control group(P<0.05).Conclusion:Continuous lumbar cistern drainage combined with antibiotics has a high effective rate in the treatment of intracranial infection,which can reduce the inflammatory response and shorten the improvement time of clinical symptoms.