腰穿与腰大池引流结合鞘内注射治疗脑出血侧脑室外引流术后颅内感染疗效比较

目的：探讨腰大池引流结合鞘内注射治疗脑出血侧脑室外引流术后颅内感染的效果。方法回顾性分析2010年10月至2015年9月我院收治的140例侧脑室引流术后颅内感染患者的临床资料，按照治疗方式的不同分为腰穿组和引流组，每组各70例。其中腰穿组患者接受腰椎穿刺鞘内注射治疗，引流组患者接受腰大池引流鞘内注射治疗，所有患者均按颅内感染常规治疗进行基础治疗，对比分析两组患者的治愈效果、治愈率和不良反应发生情况。结果两种方法治疗脑出血侧脑室外引流术后颅内感染均有效，但引流组的治愈率为90.00%(63/70)，明显高于腰穿组的61.43%(43/70)，差异有统计学意义(P<0.05)；腰穿组的平均有效治疗时间为(9.47±2.4) d，明显长于引流组的(6.25±1.8) d，且治疗过程中腰穿组诉腰痛的患者例数明显多于引流组(15例vs 16例)，两组患者相比差异有统计学意义(P<0.05)。结论采用腰大池引流结合鞘内注射治疗脑出血侧脑室外引流术后颅内感染疗效确切，不良反应少，值得在临床上推广应用。

Comparison on clinical effect of lumbar puncture and lumbar drainage combined with intrathecal injection in treatment of postoperative intracranial infection after paraventriculostomy

Objective To explore the effect of lumbar puncture and lumbar drainage combined with intrathecal injection on treatment of postoperative intracranial infection after paraventriculostomy. Methods A total of 140 pa-tients with postoperative intracranial infection after paraventriculostomy in our hospital from October 2010 to September 2015 were retrospectively reviewed. According to different treatment methods, all patients were divided into the lumbar puncture group and the lumbar drainage group, with 70 patients in each group. The lumbar puncture group received intra-thecal injection combined with lumbar puncture, and the lumbar drainage group received lumbar drainage combined with intrathecal injection. All patients were treated with routine treatment of intracranial infection. The effect of the cure, the cure rate and the incidence of adverse reactions were compared between two groups. Results Both methods had good effect in the treatment of postoperative intracranial infection after paraventriculostomy, but the cure rate of the lum-bar drainage group 90.00%(63/70)] was significantly higher than of the lumbar puncture group 61.43%(43/70), with statistically significant difference (P<0.05). The average effective treatment time in the lumbar puncture group was (9.47±2.4) days, which was significantly longer than that in the lumbar drainage group of (6.25±1.8) days, and the cases of patients with lumbago in the lumbar puncture group was significantly more than the lumbar drainage group (15 vs 16), with statistically significant difference (P<0.05). Conclusion Lumbar drainage combined with intrathecal injection in treatment of postoperative intracranial infection after paraventriculostomy is effective, which has less adverse reactions. It is worthy to be clinical popularized and applied.