美罗培南双途径给药在重症颅脑损伤术后颅内感染患者辅助治疗的效果评价

Efficacy of meropenem administered via a dual-route approach as an adjuvant therapy in intracranial in-fection after severe traumatic brain injury

目的探讨美罗培南双途径给药在重症颅脑损伤术后颅内感染患者的治疗效果。方法选取我院2019年10月至2021年1月重症颅脑损伤术后颅内感染患者112例,按给药途径不同分为对照组(56例)、研究组(56例)。对照组采用静脉滴注给药,研究组采用静脉滴注+脑室内注射给药。观察2组总有效率、术后恢复指标(术后住院时间、体征稳定时间)、治疗前后脑脊液生化指标(白细胞计数、氯化物、葡萄糖)及颅内压、脑脊液相关因子[肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、脑钠肽变化。结果研究组总有效率96.4%高于对照组80.4%(P<0.05);研究组术后恢复时间、体征稳定时间均短于对照组(P<0.05);治疗后研究组氯化物、葡萄糖、颅内压、白细胞计数改善水平优于对照组(P<0.05);治疗后研究组TNF-α、IL-6、hs-CRP、脑钠肽低于对照组(P<0.05)。结论美罗培南双途径给药能有效降低重症颅脑损伤术后颅内感染患者颅内压,提高治疗效果,减轻炎症反应,促进病情恢复。

Objective To investigate the efficacy of meropenem administered via a dual-route approach as an adjuvant therapy in intracranial infection after severe traumatic brain injury.Methods A total of 112 pa-tients with intracranial infection after severe traumatic brain in our hospital between from October 2019 and Jan-uary 2021 were included and divided into the control group(n=56)and study group(n=56)according to the route of administration.The control group was medicated via by intravenous irrigation,while the study group was medi-cat-ed via intravenous irrigation plus intracerebroventricular injection.The two groups were compared for the total treatment response,postoperative recovery(length of hospital stay after surgery,time to stability of vital signs),as well as biochemistry of cerebrospinal fluid(white blood cell count,chlorides,glucose),intracranial pressure,cere-brospinal fluid related factors[tumor necrosis factor(TNF)-α],interleukin-6(IL-6),and high-sensitivity C-reactive protein(hs-CRP),brain natriuretic peptide]before and after treatment.Results The total treatment response was 96.4%in the study group,which was higher than that in the control group(80.4%,P<0.05).After treatment,the time to postoperative recovery and the time to stability of vital signs were shorter in the study group compared with the control group(P<0.05);the improvement in intracranial pressure and white blood cell count was greater in the study group compared with the control group(P<0.05);the levels of TNF-α,IL-6,hs-CRP,and brain natriuretic peptide were lower in the study group than those in the control group(P<0.05).Conclusion In patients with in-tracranial infection after severe traumatic brain injury,meropenem given via adual-route approach can effectively reduce intracranial pressure,improve the reatment efficacy,alleviate inflammatory response,and promote patient recovery from the condition.