摘要
目的评价利奈唑胺和万古霉素治疗神经外科手术后发生颅内感染患者的疗效和安全性。方法选取2016年10月至2018年9月在郑州市第一人民医院神经外科治疗的神经外科术后95例颅内感染患者为研究对象。根据患者应用的抗菌药物,将其分为万古霉素组(A组,52例)与利奈唑胺组(B组,43例)。A、B组分别应用盐酸万古霉素与利奈唑胺注射液进行抗菌治疗,比较两组患者治疗前后脑脊液检测指标、临床疗效、抗菌药物费用与治疗时间。结果A、B组患者总有效率比较差异未见统计学意义(94.2%比90.7%,P=0.512)。治疗后,两组患者中性粒细胞百分比、白细胞计数、葡萄糖、红细胞计数与蛋白质等脑脊液指标均较治疗前改善(P均<0.05),但上述指标两组比较差异未见统计学意义(P>0.05)。A、B组不良反应发生率及抗菌药物的治疗时间比较差异未见统计学意义(P>0.05);但A组抗菌药物治疗费低于B组[(5838.60±2659.98)元比(9324.81±4265.36)元,P<0.05]。结论利奈唑胺与万古霉素治疗革兰阳性菌导致的神经外科术后颅内感染患者的疗效及安全性相似,万古霉素的经济性优于利奈唑胺。对于无过敏和明显肝、肾功能不全者,万古霉素可用作首选治疗药物。
Objective To evaluate the efficacy and safety of linezolid and vancomycin in the treatment of patients with intracranial infection after neurosurgery. Methods Ninety-five patients with intracranial infection after neurosurgery in the First People’s Hospital of Zhengzhou from October 2016 to September 2018 were selected. Patients were divided into vancomycin group (group A, n=52) and linezolid group (group B, n=43) according to whether using antibiotics. Patients in group A and group B were treated with vancomycin hydrochloride and linezolid, respectively for antibacterial treatment. The preoperative and postoperative cerebrospinal fluid test indicators, clinical efficacy, antibacterial cost and treatment time were compared between the two groups. Results There was no significant difference in the total effective rate of patients between group A and group B (94.2% vs. 90.7%, P=0.512). After treatment, the cerebrospinal fluid indexes including neutrophil percentage, white blood cell count, glucose, red blood cell count and protein were significantly improved in both groups (all P<0.05);however, there was no statistical difference in the above indicators between the two groups after treatment (all P>0.05). There was no significant difference in the incidence of adverse reactions and the treatment time of antibiotics between group A and group B (P>0.05). The cost of antibiotics in group A was lower than that in group B,(5 838.60±2 659.98) yuan vs.(9 324.81±4 265.36) yuan, P<0.05. Conclusions The efficacy and safety of linezolid and vancomycin in the treatment of postoperative neurosurgical intracranial infection caused by Gram-positive bacteria are similar. The vancomycin is more economical than linezolid. For patients without allergies and significant liver or kidney dysfunction, vancomycin can be used as first choice in the treatment.
作者
游广辉
董娟
戚志平
马琳
You Guanghui;Dong Juan;Qi Zhiping;Ma Lin(Department of Pharmacy, the First People’s Hospital of Zhengzhou, Zhengzhou 450000, China)
出处
《中国实用医刊》
2019年第15期94-97,共4页
Chinese Journal of Practical Medicine
关键词
颅内感染
利奈唑胺
万古霉素
疗效
Intracranial infection
Linezolid
Vancomycin
Therapeutic effect
