联合应用替加环素治疗鲍曼不动杆菌颅内感染疗效分析

Effects of Combined Tigecycline in Treatment of Intracranial Infection with Acinetobacterbaumannii

目的探讨联合应用替加环素治疗鲍曼不动杆菌颅内感染的临床疗效。方法回顾性分析40例鲍曼不动杆菌颅内感染患者的病历资料,按照治疗方案不同分为观察组和对照组各20例,2组一般资料比较差异无统计学意义(P>0.05)。观察组给予替加环素100 mg静脉注射1次/12 h,鞘内注射4 mg替加环素(浓度为1 mg·mL^(-1))1次·d^(-1),同时联合应用头孢哌酮钠舒巴坦钠治疗(3 g,q8h);对照组给予美罗培南(2 g,q8h)+头孢哌酮钠舒巴坦钠治疗(3 g,q8h)。比较2组患者治疗前后脑脊液各项指标变化情况及疗效。结果治疗1月后,观察组脑脊液白细胞计数及蛋白质含量均低于对照组,葡萄糖含量高于对照组,差异有统计学意义(P<0.05);观察组治愈率较对照组高,差异有统计学意义(P<0.05)。结论联合静脉及鞘内注射替加环素治疗鲍曼不动杆菌颅内感染可显著改善患者脑脊液各项指标并提高治愈率,疗效良好,值得临床推广应用。

Objective To explore the clinical effect of combined tigecycline in the treatment of intracranial infection with Acinetobacterbaumannii.Methods A total of 40 patients with intracranial infection with Acinetobacterbaumannii were randomly divided into observation group and control group based on different treatment plans,with 20 patients in each group.They were retrospectively analyzed.There was no significant difference in general data between the two groups(P>0.05).The observation group was treated with tigecycline combined with cefoperazonesulbactam.Tigecycline was intravenously administered at 100 mg 1/12 h.Intrathecal injection of 4 mg tigecycline with the concentration of 1 mg/ml was administered once a day.The control group was treated with meropenem(2 g,q8h)and cefoperazonesulbactam(3 g,q8h).Various indicators of cerebrospinal fluid and the therapeutic efficacy were compared between the two groups before and after treatment.Results After 1 month of treatment,the number of white blood cells and the level of protein in the cerebrospinal fluid of the observation group were lower than those of the control group,and glucose level in the cerebrospinal fluid was higher than that of the control group,with statistically significant difference(P<0.05).The cure rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion Combination of intravenous and intrathecal injection of tigecycline in the treatment of intracranial infection with Acinetobacterbaumannii can significantly improve the indicators of cerebrospinal fluid and increase the cure rate of patients.It is worthy of clinical application.