脑脊液置换联合鞘内注药治疗结核性脑膜炎疗效观察

目的探讨脑脊液置换联合鞘内注药治疗结核性脑膜炎(TBM)的临床效果。方法 149例TBM患者分为对照组和观察组,对照组67例患者给予常规抗结核药物治疗,观察组82例患者在此基础上给予脑脊液置换和鞘内注药联合治疗,对2组患者的治疗效果、临床症状、脑脊液蛋白含量、脑脊液白细胞计数及脑脊液压力进行比较。结果观察组患者治疗有效率显著高于对照组(P<0.05);观察组患者发热和头痛消失时间、脑脊液压力及脑脊液蛋白含量和脑脊液白细胞计数恢复时间、住院时间均显著短于对照组(P<0.05);2组患者治疗后脑脊液蛋白含量、脑脊液白细胞计数和脑脊液压力均显著低于治疗前(P<0.05);治疗后观察组患者脑脊液蛋白含量、脑脊液白细胞计数和脑脊液压力均显著低于对照组(P<0.05)。结论脑脊液置换联合鞘内注药治疗TBM效果显著,可快速改善患者的临床症状及脑脊液生化指标。

Effect of cerebrospinal fluid replacement combined with intrathecal injection for tuberculous meningitis

Objective To explore the effect of cerebrospinal fluid replacement combined with intrathecal injection for the treatment of tuberculous meningitis(TBM).Methods One hundred and forty-nine patients with TBM were divided into control group and observation group.Sixty-seven patients in control group were treated with conventional antituberculosis drugs,based on this,eighty-two patients in observation group were treated with cerebrospinal fluid replacement combined with intrathecal injection.The therapeutic efficacy,clinical symptom,protein level of cerebrospinal fluid,white blood count of cerebrospinal fluid and cerebrospinal fluid pressure were compared between the two groups.Results The effective rate in observation group was significantly higher than that in control group(P<0.05).The extinction time of fever and headache,recovery time of cerebrospinal fluid pressure,protein level and white blood count of cerebrospinal fluid,and hospitalization time in observation group were significantly shorter than those in control group(P<0.05).Compared with pretreatment,the cerebrospinal fluid protein level,white blood count and pressure of cerebrospinal fluid were significantly lower after treatment in the two groups(P<0.05).After treatment,the cerebrospinal fluid protein level,white blood count and pressure of cerebrospinal fluid in observation group were significantly lower than those in control group(P<0.05).Conclusion The treatment of cerebrospinal fluid replacement combined with intrathecal injection can obtain significant effect with the quick improvement of patient′s clinical symptom and biochemical indicators of cerebrospinal fluid.