摘要
目的研究美罗培南鞘内注射与静脉滴注联用治疗颅脑外伤术后颅内感染的临床疗效评价。方法选择2016年9月至2018年10月我院神经外科就诊的颅脑外伤术后颅内感染66例患者作为受试者,运用随机数字表法分为对照组、试验A组以及试验B组,各22例。对照组静脉滴注头孢曲松和腰大池置管脑脊液外引流术治疗;试验A组在对照组基础之上,给予美罗培南鞘内注射;试验B组在试验A组基础之上,给予美罗培南静脉滴注;观察记录治疗前、治疗后第7天CSF蛋白质含量及白细胞计数、血生化相关降钙素原水平及白细胞计数。统计两组痊愈患者的住院时间、期间住院费用及不良反应发生情况。结果试验A组及B组治愈率明显高于对照组(P<0.05)。试验B组治愈率明显高于试验A组(χ2=4.956,P<0.05)。试验A组及B组住院时间明显短于对照组且住院费用要低于对照组(P<0.05)。试验B组相较于试验A组来说住院费用无统计学差异(t=1.045,P>0.05),但是住院时间更短(t=4.945,P<0.05)。试验A组及B组不良反应发生率明显低于对照组(P<0.05)。试验B组相较于试验A组来说不良反应发生率更低(χ2=5.194,P<0.05)。治疗前,三组CSF检查的蛋白质含量及白细胞计数均无统计学差异(P>0.05)。接受治疗后,试验A组及B组CSF检查的蛋白质含量及白细胞计数明显低于对照组(P<0.05)。试验B组相较于试验A组来说CSF检查白细胞计数无统计学差异(t=0.109,P>0.05),但是蛋白质含量下降明显(t=5.848,P<0.05)。治疗前,三组血生化检查的降钙素原水平及白细胞计数均无统计学差异(P>0.05)。接受治疗后,试验A组及B组血生化检查的降钙素原水平及白细胞计数明显低于对照组(P<0.05)。试验B组相较于试验A组来说血生化检查的降钙素原水平及白细胞计数下降明显(t=28.861,t=3.108 P<0.05)。结论美罗培南鞘内注射与静脉滴注联用疗效显著,无严重的毒副作用,值得在临床推广使用。
Objective To evaluate the clinical efficacy of intrathecal injection of meropenem and intravenous drip in the treatment of intracranial infection after craniocerebral trauma.Methods Sixty-six patients with intracranial infection after craniocerebral trauma treated by neurosurgery in our hospital from September 2016 to October 2018 were selected as subjects,and were randomly divided into control group,test group A and test group B by random number table.22 cases each.The control group received intravenous infusion of ceftriaxone and cerebrospinal fluid replacement;the test group A was given intrathecal injection of meropenem on the basis of the control group;the test group B was given intravenous infusion of meropenem on the basis of the test group A;CSF protein content and white blood cell count,blood biochemical related procalcitonin level and white blood cell count were recorded before treatment and on the 7 th day after treatment.The hospitalization time,hospitalization expenses and adverse reactions occurred in the two groups of patients who recovered.Results The cure rate of group A and group B was significantly higher than that of the control group(P<0.05).The cure rate of test group B was significantly higher than that of test group A(χ2=4.956,P<0.05).The hospital stay in group A and group B was significantly shorter than that in the control group,and the hospitalization cost was lower than that in the control group(P<0.05).There was no significant difference in hospitalization costs between experimental group B and experimental group A(t=1.045,P>0.05),but hospitalization time was shorter(t=4.945,P<0.05).The incidence of adverse reactions in group A and group B was significantly lower than that in the control group(P<0.05).The incidence of adverse reactions in test group B was lower than that in test group A(χ2=5.194,P<0.05).There was no significant difference in protein content and white blood cell count between the three groups before treatment(P>0.05).After treatment,the protein content and white blood cell count of cerebration fluid in group A and group B were significantly lower than those in the control group(P<0.05).There was no significant difference in white blood cell count between group C and group A(t=0.109,P>0.05),but protein content decreased significantly(t=5.848,P<0.05).There was no significant difference in reciprocal levels and white blood cell counts between the three groups before treatment(P>0.05).After treatment,the reciprocal and white blood cell counts in group A and group B were significantly lower than those in the control group(P<0.05).In test group B,reciprocal levels and white blood cell counts in blood biochemical tests were significantly lower than test group A(t=28.861,t=3.108 P<0.05).Conclusion Intrathecal injection of meropenem and intravenous drip is effective.It has no serious side effects and is worthy of clinical use.
作者
郑雪峰
王文浩
林洪
胡康
黄巍
刘长春
张明升
Zheng Xuefeng;Wang Wenhao;Lin Hong(Department of Neurosurgery,the 909th Hospital of the People's Liberation Army Joint Service Support Force(Southeast Hospital affiliated to Xiamen University),Zhang zhou 363000,China)
出处
《立体定向和功能性神经外科杂志》
2019年第2期79-84,共6页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
美罗培南
鞘内注射
静脉滴注
颅脑外伤
颅内感染
Meropenem
Intrathecal injection
Intravenous drip
Craniocerebral trauma
Intracranial infection
作者简介
通讯作者:王文浩,414045087@qq.com
