静脉联合鞘内或脑室内注射多黏菌素对多重耐药鲍曼不动杆菌#br# 颅内感染疗效及安全性Meta分析

目的 系统评价多黏菌素静脉联合鞘内或脑室内注射对多重耐药鲍曼不动杆菌的疗效及安全性。方法 计算机检索PubMed、Embase、CNKI、VIP、万方数据库等数据库，检索时间为建库至2019年6月，筛选有关多黏菌素静脉联合鞘内或脑室内给药治疗多重耐药鲍曼不动杆菌感染的文献，采用RevMan 5.3软件对提取的数据进行Meta分析。结果 纳入7篇文献、178例患者。Meta分析结果显示，静脉联合鞘内或脑室内组的临床死亡率(OR=0.18, 95%CI：0.09~0.37, P＜0.00001)低于静脉组、细菌清除率(OR=20.40, 95%CI：5.94~70.12, P＜0.00001)高于静脉组；两组不良反应发生率无统计学差异(OR=0.60, 95%CI: 0.16~2.23, P=0.44)。结论 多黏菌素静脉联合鞘内或脑室内给药治疗多重耐药鲍曼不动杆菌颅内感染疗效优于静脉滴注，安全性无显著差异。

Meta-analysis on efficacy and safety of intravenous plus intrathecal or intracerebral ventricle injection of polymyxin against intracranial infections due to MDR Acinectobacter baumannii

Objective To systematically review the efficacy of intravenous plus intrathecal or intracerebral ventricle injection of polymyxin against intracranial infections due to MDR/XDR Acinectobacter baumannii. Methods Computers were used to search documents about intravenous plus intrathecal or intracerebral ventricle injection of polymyxin against intracranial infections due to MDR/XDR Acinectobacter baumannii in PubMed, Embase, CNKI, VIP and Wanfang Data from their inception to June 2019. RevMan 5.3 software was used to carry out Meta-analysis. Results A total of seven documents were involved, including 178 patients. Meta-analysis results showed that clinical mortality rate of the ITV＋ITC group was lower than that of the ITV group (OR=0.18, 95%CI: 0.09~0.37, P＜0.00001), bacterial eradication rate of the ITV＋ITC group overtop that of the ITV group(OR=20.40, 95%CI: 5.94~70.12, P＜0.00001), but there was no statistical difference in the incidence of averse drug reactions (OR=0.60, 95%CI: 0.16~2.23, P=0.44). Conclusion The administration of intravenous plus intrathecal or intracerebral ventricle injection was superior to intravenous administration, and there was no significant difference in safety.