摘要
目的调查腰大池引流联合鞘内注射治疗开颅术后颅内感染患者的疗效,为临床寻找有效的治疗方法提供依据。方法 2010年1月-2013年12月62例颅内感染患者随机分为两组,观察组31例患者采用腰大池引流联合鞘内注射治疗,对照组31例患者采用静脉治疗,比较观察两组患者感染病原菌种类、白细胞计数变化和临床疗效。结果观察组和对照组检出金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌、大肠埃希菌和变形菌属分别占45.2%、25.8%、9.7%、16.1%、3.2%和41.9%、22.6%、16.1%、12.9%、6.5%,两组比较差异无统计学意义;观察组治疗前、治疗后1、5d脑脊液白细胞计数逐渐下降(P<0.05);而对照组白细胞计数无明显变化(P>0.05);观察组治疗后1、5d白细胞计数明显低于对照组(P<0.05);观察组痊愈率和总有效率分别为61.3%和90.3%,明显高于对照组的12.9%和58.1%(χ2=15.552,5.905,P<0.05)。结论腰大池引流联合鞘内注射治疗开颅术后颅内感染患者,能够明显提高疗效,减轻感染。
OBJECTIVE To observe the clinical efficacy of lumbar cisterna drainage combined with intrathecal injec‐tion in treatment of the craniotomy patients with postoperative intracranial infections so as to provide guidance for effective clinical treatment .METHODS A total of 62 patients with intracranial infections who were treated in the hospital from Jan 2010 to Dec 2013 were randomly divided into two groups .The observation group with 31 cases was treated with the lumbar cisterna drainage combined with intrathecal injection ,while the control group with 31 cases was given the intravenous therapy .The species of pathogens causing the infections ,change of white blood cells ,and clinical efficacies were observed and compared between the two groups of patients .RESULTS The isola‐ted Staphylococcus aureus strains accounted for 45 .2% in the observation group ,41 .9% in the control group;the isolated Staphylococcus epidermidis strains accounted for 25 .8% in the observation group ,22 .6% in the control group;the isolated Pseudomonas aeruginosa strains accounted for 9 .7% in the observation group ,16 .1% in the control group ;the isolated Escherichia coli strains accounted for 3 .2% in the observation group ,12 .9% in the control group;the isolated Proteus sp p strains accounted for 3 .2% in the observation group ,6 .5% in the control group;there was no significant difference between the two groups .The white blood cells counts in the cerebrospi‐nal fluid were gradually decreased in the observation group before the treatment or 1 ,5 days after the treatment （P〈0 .05） ,however ,the white blood cells counts did not change significantly in the control group （P〉0 .05）;the white blood cells counts of the observation group were significantly lower than those of the control group after the treatment for 1 or 5 days （P〈0 .05） .The cure rate was 61 .3% in the observation group ,significantly higher than 12 .9% in the control group ;the total effective rate was 90 .3% in the observation group ,significantly higher than 58 .1% in the control group （χ2 = 15 .552 ,5 .905 ,P〈 0 .05） .CONCLUSION The lumbar cisterna drainage combined with intrathecal injection can remarkably improve the clinical efficacy in the treatment of the craniotomy patients with postoperative intracranial infections and reduce the incidence of infections ,and it is worthy to be pro‐moted in the hospital .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第22期5206-5208,共3页
Chinese Journal of Nosocomiology
基金
河南省教育厅科学技术研究基金项目(12B180005)
关键词
腰大池引流
鞘内注射
颅内感染
Lumbar cisterna drainage
Intrathecal injection
Intracranial infection
