摘要 目的探究鞘内注射万古霉素联合美罗培南治疗重症颅脑创伤(STBI)术后颅内感染的疗效。方法回顾性分析武警特色医学中心2017年1月-2019年12月开颅手术的80例STBI术后颅内感染患者,根据入院时间分别纳入对照组和研究组各40例,对照组以静脉注射万古霉素联合美罗培南治疗,研究组以鞘内注射万古霉素联合美罗培南治疗,观察两组患者的临床疗效及感染控制时间,比较两组患者外周血感染指标[白细胞(WBC)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)]及脑脊液常规生化(WBC、蛋白、葡萄糖水平)情况,并对鞘内注射两种药物的安全性进行评价。结果研究组的临床有效率高于对照组(P<0.05),且感染控制时间更短(P<0.05)。与治疗前相比,治疗后两组患者外周血中WBC、CRP、IL-6均降低(P<0.05),且治疗后研究组的上述指标低于对照组,差异有统计学意义(P<0.05)。与治疗前相比,治疗后两组患者脑脊液中葡萄糖水平升高(P<0.05),WBC及蛋白水平降低(P<0.05),且治疗后研究组上述指标变化更显著,差异有统计学意义(P<0.05)。研究组与对照组间不良反应发生率比较,无统计学差异。结论鞘内注射万古霉素联合美罗培南可有效控制重症颅脑创伤患者术后颅内感染,安全性较高,具有一定的临床推广价值。 OBJECTIVE To explore the effect of intrathecal injection of vancomycin combined with meropenem on treatment of the severe traumatic brain injury(STBI)patients with postoperative intracranial infection.METHODS A total of 80 STBI patients who underwent craniotomy and had postoperative intracranial infection in Characteristic Medical Center of Chinese People’s Armed Police Force from Jan 2017 to Dec 2019 were retrospectively analyzed and were divided into the control group and the study group according to the time of admission,with 40 cases in each group.The control group was treated with intravenous injection of vancomycin combined with meropenem,while the study group was given intrathecal injection of vancomycin combined with meropenem.The clinical therapeutic effect and time of control of infection were observed,and the levels of peripheral blood[white blood cell(WBC),C-reactive protein(CRP),interleukin-6(IL-6)]and cerebrospinal fluid routine biochemical indexes(WBC,protein,glucose)were observed and compared between the two groups of patients,and the safety of intrathecal injection of the two drugs was evaluated.RESULTS The effective rate of clinical treatment of the study group was significantly higher than that of the control group(P<0.05),the time of control of infection was significantly shorter in the study group than in the control group(P<0.05).The levels of peripheral blood WBC,CRP and IL-6 of the two groups of patients were significantly lower after the treatment than before the treatment(P<0.05),and the levels of above indexes of the study group were significantly lower than those of the control group(P<0.05).The cerebrospinal fluid glucose level of the two groups of patients was significantly higher after the treatment than before the treatment(P<0.05),the levels of WBC and protein were significantly lower after the treatment than before the treatment(P<0.05),the above indexes changed more significantly in the study group than in the control group after the treatment(P<0.05).There was no significant
出处 《中华医院感染学杂志》 CAS CSCD 北大核心 2021年第6期881-885,共5页 Chinese Journal of Nosocomiology
基金 国家自然科学基金资助项目(81671222) 武警部队军事理论研究计划基金资助项目(WJJY20JL0473) 天津市滨海新区卫生计生委科技基金资助项目(2017BWKY035)。
