美罗培南联合万古霉素鞘内注射治疗开颅术后颅内感染的临床观察

发布时间：2019-07-19 12:19

【摘要】：目的:观察美罗培南联合万古霉素鞘内注射治疗开颅术后颅内感染的临床疗效及安全性。方法:采用回顾性分析方法,选择我院2014年5月-2016年6月开颅术后颅内感染患者46例,按照治疗方法分为对照组(20例)和观察组(26例)。对照组患者给予注射用盐酸万古霉素1.0 g,ivgtt,bid+注射用美罗培南2.0 g,ivgtt,tid;观察组患者行腰大池置管引流释放脑脊液后,缓慢给予注射用盐酸万古霉素20 mg,用0.9%氯化钠注射液2 mL冲管后,缓慢给予注射用美罗培南20 mg,bid。两组患者均治疗2周。观察两组患者脑脊液细菌培养情况、临床疗效、治愈时间及其治疗费用,并记录不良反应和治疗后6个月的后遗症发生情况。结果:46例患者脑脊液细菌培养阳性率为45.7%。观察组患者痊愈率(92.3%)显著高于对照组(65.0%),治愈时间及其治疗费用均显著短/低于对照组;总不良反应发生率(7.7%)显著低于对照组(40.0%),后遗症发生率(3.8%)显著低于对照组(20.0%),差异均有统计学意义(P0.05)。结论:美罗培南联合万古霉素鞘内注射治疗开颅术后颅内感染的疗效优于静脉给药,可显著缩短治疗时间,降低治疗费用,且安全性较好。
[Abstract]:Objective: to observe the clinical efficacy and safety of meropenem combined with vancomycin intrathecal injection in the treatment of intracranial infection after craniotomy. Methods: 46 patients with intracranial infection after craniotomy in our hospital from May 2014 to June 2016 were selected and divided into control group (n = 20) and observation group (n = 26) according to the treatment method. The patients in the control group were given vancomycin hydrochloric acid 1.0 g, ivgtt, bid for meropenem 2.0 g, ivgtt, tid. after drainage and release of cerebrospinal fluid in the lumbar cistern, the patients in the observation group were slowly given vancomycin hydrochloric acid 20 mg, with 0.9% sodium chloride injection 2 mL, and meropenem 20 mg,bid. for injection Both groups were treated for 2 weeks. The bacterial culture, clinical curative effect, cure time and treatment cost of cerebrospinal fluid in the two groups were observed, and the adverse reactions and sequelae 6 months after treatment were recorded. Results: the positive rate of bacterial culture in cerebrospinal fluid of 46 patients was 45.7%. The cure rate (92.3%) in the observation group was significantly higher than that in the control group (65.0%), the cure time and treatment cost were significantly shorter / lower than those in the control group, the total incidence of adverse reactions (7.7%) was significantly lower than that in the control group (40.0%), and the incidence of sequelae (3.8%) was significantly lower than that in the control group (20.0%). Conclusion: the efficacy of meropenem combined with vancomycin intrathecal injection in the treatment of intracranial infection after craniotomy is better than that of intravenous administration, which can significantly shorten the treatment time, reduce the cost of treatment, and is safe.
【作者单位】：民航总医院重症医学科;
【分类号】：R651.1

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