摘要
目的观察对术后颅内感染和(或)脑脊液漏患者实施持续腰大池引流治疗的临床效果。方法 41例颅脑手术术后出现颅内感染和(或)脑脊液漏患者,均在常规治疗的基础上均给予持续腰大池引流术,对于单纯脑脊液漏患者在引流同时给予静脉抗感染治疗,对于颅内感染或颅内感染合并脑脊液漏患者在腰大池引流的同时给予鞘内注射抗生素治疗,注射完毕夹闭引流管2 h,2 h后打开继续引流,根据感染实际情况控制注射药物剂量。分别于引流前、引流后1周和引流后2周观察体温(T)、白细胞(WBC)、血沉(ESR)及C反应蛋白(CRP)变化情况,详细记录患者持续腰大池引流后1周及2周脑脊液变化情况。结果 41例患者引流后1、2周T、WBC、ESR及CRP与引流前比较差异均具有统计学意义(P<0.01)。患者引流后1周的平均引流量为(154.85±15.32)ml/d,引流后2周患者平均引流量为(20.43±3.32)ml/d,引流后1周与引流后2周比较差异有统计学意义(F=162.420,P<0.05)。结论持续腰大池引流在颅脑术后出现颅内感染和(或)脑脊液漏患者治疗中疗效确切,值得临床应用与推广。
Objective To observe clinical effect by continuous lumbar cistern drainage in the treatment of patients with postoperative intracranial infection and（or）leakage of cerebrospinal fluid. Methods A total of 41 patients with postoperative intracranial infection and（or）leakage of cerebrospinal fluid after craniocerebral operation all received continuous lumbar cistern drainage in addition to conventional therapy. Patients with single leakage of cerebrospinal fluid received intravenous anti-infection treatment, and patients with intracranial infection or intracranial infection combined with leakage of cerebrospinal fluid received intrathecal injection of antibiotics, with 2 h drainage tube closure after injection, and injection dosage was made in accordance with practical infection condition. Observation was made on changes of temperature（T）, white blood cell（WBC）, erythrocyte sedimentation rate（ESR）and C-reactive protein（CRP）before and in 1, 2 weeks after drainage, along with records of cerebrospinal fluid changes in 1, 2 weeks after drainage. Results The differences of T, WBC, ESR and CRP all had statistical significance between 1 week and 2 weeks after drainage（P〈0.01）. Mean drainage volume in 1 week after drainage was（154.85±15.32）ml/d, which was（20.43±3.32）ml/d in 2 weeks, and their difference had statistical significance between 1 week and 2 weeks（F=162.420, P〈0.05）. Conclusion Continuous lumbar cistern drainage shows precisely curative effect in the treatment of patients with postoperative intracranial infection and（or）leakage of cerebrospinal fluid, and it is worth clinical application and promotion.
出处
《中国实用医药》
2016年第33期98-100,共3页
China Practical Medicine
关键词
颅内感染
脑脊液漏
持续
腰大池引流
临床疗效
Intracranial infection
Leakage of cerebrospinal fluid
Continuous
Lumbar cistern drainage
Clinical effect
