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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
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| 篇名： | 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 |
| TITLE： | |
| 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（P＜0.05）。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 clinical efficacy and safety of intrathecal injection of meropenem combined with vancomycin for intracranial infections after craniotomy. METHODS： In retrospective analysis， 46 patients with intracranial infections after craniotomy selected from our hospital during May 2014 to Jun. 2016 were divided into control group （20 cases） and observation group （26 cases） according to treatment method. Control group was given Vancomycin hydrochloride for injection 1.0 g， ivgtt， bid+Meropenem for injection 2.0 g， ivgtt， tid. After cerebrospinal fluid release of lumbar cistern drainage， observation group was given Vancomycin hydrochloride for injection 20 mg slowly， and the given Meropenem for injection 20 mg， bid， after washing tube with 0.9％ Sodium chloride injection 2 mL. Both groups received treatment for 2 weeks. Cerebrospinal fluid bacterial culture， clinical efficacy， healing time and treatment cost were observed in 2 groups， and the occurrence of ADR and sequela in 6 months after treatment were recorded. RESULTS： The positive rate of cerebrospinal fluid bacterial culture of 46 patients was 45.7％. The healing rate of observation group （92.3％） was significantly higher than that of control group （65.0％）. Healing time and treatment cost of observation group were significantly shorter or lower than control group； and total incidence of ADR （7.7％） was also significantly lower than control group （40.0％）， the incidence of sequelae （3.8％） was significantly lower than control group （20.0％）， with statistical significance （P＜0.05）. CONCLUSIONS： Therapeutic efficacy of intrathecal injection of meropenem combined with vancomycin is superior than intravenous administration for intracranial infections after craniotomy， can significantly shorten the treatment time and reduce treatment cost with good safety. |
| 期刊： | 2017年第28卷第14期 |
| 作者： | 郑一，王楠 |
| AUTHORS： | ZHENG Yi，WANG Nan |
| 关键字： | 美罗培南；万古霉素；鞘内注射；颅内感染；脑脊液 |
| KEYWORDS： | Meropenem； Vancomycin； Intrathecal injection； Intracranial infections； Cerebrospinal fluid |
| 阅读数： | 5007 次 |
| 本月下载数： | 17 次 |
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