颅内葡萄球菌感染的临床治疗研究

目的探讨应用万古霉素脑室内梯度注射并持续脑室外引流对术后颅内葡萄球菌感染的治疗作用。方法对15例术后颅内葡萄球菌感染患者，脑室穿刺置管并持续脑室外引流（continuedintraventriealcerebrospinalfluiddrainage）后于脑室内注入生理盐水2ml＋万古霉素1次／d，剂量从20mg，40mg，60mg，80rag，100mg,120mg，140mg，逐日递增。共7d。在治疗前、后监测患者体温、血白细胞、颅内压（intraeranialpressure，ICP）、脑脊液常规、生化指标及细菌培养。结果用万古霉素年脑室内注射治疗前各指标升高，治疗2～3d后逐渐下降，4—7d即出现颅内压降低、体温、白细胞计数、脑脊液生化及常规指标恢复正常；治疗前、后对比各指标明显差异（P〈0．05，P〈O．01），无并发症发生。结论应用万古霉素脑室内梯度注射并持续脑室外引流治疗颅内葡萄球菌感染疗效显著，无副作用，是临床治疗颅内葡萄球茵感染可行的方法。

Clinical investigation into the treatment of intracranial Staphylococci infection

Objective To observe the curativ effect of intracranial infection of vancomyein and continued intraventrical cerebrospinal fluid drainage on Staphylococci-induced intracranial infection after the craniotomy. Methods Fifteen patients with intracranial infection induced by Staphylococci after the craniotomy were treated by intraventrical injection of normal saline 20ml plus vancomycin and continued intraventrical cerebrospinal fluid drainage . Vancomycin doses was 20mg,40mg,60mg,80mg, lOOmg, 120mg, 140mg per day respectively 1,2,3,4,5,6 and 7 days after the operation.Results All the observed indexes were abnormal before intraventrical injection and were gradually improved 2 or 3day after the intraventrical injection .The body temperature ,intracanial pressure and cerebrospinal fluid became normal from 4 to 7day after the intraventrical injection .There significant differences in all the observed indexes before and after ttreatment were observed （P〈0.05）.No complications occurred to all patient. Conclusion The intracranial gradient infection of vancomyein and continued intraventrical eerebrospinal fluid drainage are effective and practicable for treatment of Staphylococci-induced intracranial infection.