鞘内注射万古霉素治疗脑出血患者术后颅内感染的临床价值探讨

Clinical Value of Intrathecal Injection of Vancomycin in the Treatment of Intracranial Infection after Intracerebral Hemorrhage

目的探讨鞘内注射万古霉素治疗脑出血患者术后颅内感染的临床价值。方法选取2022年1—12月在广东三九脑科医院治疗的78例脑出血后颅内感染患者为研究对象,按抽签法分为对照组和研究组,每组39例。对照组患者进行静脉注射万古霉素治疗,研究组进行鞘内注射万古霉素治疗。记录两组患者在治疗后的各项身体指标。结果研究组患者的各项生存质量得分均高于对照组,差异有统计学意义(P<0.05)。研究组患者的总有效治疗时间(6.24±2.51)d明显短于对照组(10.72±3.73)d,差异有统计学意义(t=5.458,P<0.05)。研究组患者不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。研究组患者脑脊液中表皮葡萄球菌、屎肠球菌和鲍曼不动杆菌总感染率低于对照组,差异有统计学意义(P<0.05)。研究组患者治愈率明显高于对照组,差异有统计学意义(P<0.05)。结论鞘内注射万古霉素治疗脑出血患者术后颅内感染能降低患者的不良反应发生情况,提高临床疗效,具有显著的临床价值。

Objective To investigate the clinical value of intrathecal injection of vancomycin in the treatment of intracranial infection after intracerebral hemorrhage.Methods 78 patients with intracranial infection after cerebral hemorrhage who were treated at Guangdong Sanjiu Brain Hospital from January to December 2022 were selected as the study subjects.They were divided into a control group and a study group by drawing lots,with 39 patients in each group.The control group received intravenous injection of vancomycin treatment,while the study group received intrathecal injection of vancomycin treatment.Record the various physical indicators of the two groups of patients after treatment.Results The quality of life scores of the study group patients were higher than those of the control group,the difference was statistically significant(P<0.05).The total effective treatment time of the study group patients(6.24±2.51)d was significantly shorter than that of the control group(10.72±3.73)d,the difference was statistically significant(t=5.458,P<0.05).The incidence of adverse reactions in the study group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The total infection rates of Staphylococcus epidermidis,Enterococcus faecalis,and Acinetobacter baumannii in the cerebrospinal fluid of patients in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The cure rate of patients in the study group was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Intrathecal injection of vancomycin in the treatment of postoperative intracranial infection in patients with cerebral hemorrhage can reduce the incidence of adverse reactions and improve clinical efficacy,with significant clinical value.