万古霉素结合美罗培南在重症颅脑损伤术后颅内感染患者中的应用效果

Effect of Vancomycin Combined with Meropenem in Patients with Postoperative Intracranial Infection after Severe Traumatic Brain Injury

目的分析万古霉素结合美罗培南在重症颅脑损伤术后颅内感染患者中的应用效果。方法选取兰陵县人民医院神经外科2018年5月—2022年5月收治的80例重症颅脑损伤手术发生颅内感染患者为研究对象,根据随机数字表法将其分为对照组与观察组,各40例。对照组行腰椎池引流以释放脑脊液后给予万古霉素鞘内注射抗感染治疗,观察组在对照组基础上联用美罗培南治疗。比较两组临床疗效、炎症反应指标水平、脑脊液常规指标水平、不良反应发生情况。结果观察组症状消退时间为(11.50±2.50)d,短于对照组(13.50±2.50)d,差异有统计学意义(P<0.05)。观察组治愈率高于对照组,差异有统计学意义(P<0.05)。两组缓解率比较,差异无统计学意义(P>0.05)。治疗后,观察组C反应蛋白、白细胞介素-1β、肿瘤坏死因子-α水平均低于对照组,组间差异有统计学意义(P<0.05);观察组白细胞计数、S-100蛋白水平均低于对照组,组间差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针对重症颅脑损伤术后颅内感染患者采用万古霉素联合美罗培南治疗有利于促进症状消失,抑制颅内炎性脑脊液,并且不会增加严重不良反应发生率。

Objective To analyze the effects of vancomycin combined with meropenem in patients with intracranial infection after severe traumatic brain injury surgery.Methods Eighty patients with intracranial infection after severe craniocerebral injury surgery at the Neurosurgery Department of Lanling County People's Hospital from May 2018 to May 2022 were selected as the research subjects.According to the random number table method,they were divided into a control group and an observation group,with 40 patients in each group.The control group underwent lumbar spinal drainage to release cerebrospinal fluid and were given intrathecal injection of vancomycin for anti infection treatment.The observation group received combined use of meropenem on this basis of the control group.Compare the clinical efficacy,inflammatory response index levels,cerebrospinal fluid routine index levels,and incidence of adverse reactions between two groups.Results The observation group had a symptom resolution time of(11.50±2.50)days,which was shorter than(13.50±2.50)days in the control group,and the difference was statistically significant(P<0.05).The cure rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the remission rate between the two groups(P>0.05).After treatment,the levels of C-reactive protein,interleukin-1β,and tumor necrosis factor-αin the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05);the white blood cell count and S-100 protein level in the observation group were lower than those in the control group, and the differences between the groups were statistically significant(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion The use of vancomycin combined with meropenem in the treatment of postoperative intracranial infection in patients with severe traumatic brain injury is beneficial for promoting symptom disappearance, inhibiting intracranial inflammatory cerebrospinal fluid, and does not increase the incidence of serious adverse reactions.