摘要
目的研究阿米卡星鞘注治疗开颅术后颅内感染的临床疗效与安全性。方法选择该科近5年来应用阿米卡星鞘内注射治疗的开颅术后颅内感染病例共30例,作回顾性研究分析,判断阿米卡星对颅内感染致病菌的敏感性,鞘注剂量、疗程与临床疗效的关系及其CNS毒副反应。结果阿米卡星对颅内感染致病菌的敏感比例为15/17(88%),治愈率为86.7%。颅内感染控制时间,无CSF漏组和有CSF漏组相比,明显缩短(P<0.05)。阿米卡星鞘注可使患者颅内感染迅速得到控制,其鞘注药物总量和CSF中WBC计数、糖定量、体温及颅内压等颅内感染监测指标之间均呈负相关(r=-0.8037,-0.7135,-0.7419,-0.6872;P<0.05)。仅有3例出现轻度神经系统毒副反应,很快恢复。结论阿米卡星对大多数颅内感染的致病菌敏感,临床疗效显著,无明显CNS毒性作用。
[Objective] To evaluate the clinical efficacy and safety of intrathecal Amikacin in the treatment of intraeranial infection. [Methods] A retrospective study was made to 30 consecutive cases of intraeranial infection treated with intrathecal Amikacin within recent 5 years to evaluate the sensitivity of Amikacin against the germs which lead to the intracranial infections; the relations of intrathecal doses with therapeutic period, clinical efficacy and safety; the CNS toxicity effect was also considered. [Results] The sensitivity ratio of Amikacin against etiologic agent in intracranial infections was 15 to 17（88.0%）. The period for intracranial infection to be controlled was shortened in cases without CSF leakage compared with cases with CSF leakage （P 〈0.05）. The clinical signs and symptoms of intracranial infection could be improved rapidly after intrathecal Amikacin administration. There was a negative relativity between the general doses of intrathecal Amikacin and monitoring parameters of intracranial infection such as WBC counts of CSF, glucose value of CSF, temperature and ICP（r=-0.8037, -0.7135, -0.7419, -0.6872; P 〈0.05）. Only 3 cases showed moderate CNS neurotoxic effects, and all recovered in short time. [Conclusion] Most of etiologic agents of intracranial infections are susceptible to Amikacin, and no apparent neurotoxic effects are observed.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2006年第16期2514-2516,2519,共4页
China Journal of Modern Medicine
关键词
阿米卡星
鞘内注射
神经外科手术
颅内感染
amikaein
intratheeal injection
neurosurgery operation
intraeranial infection
