摘要
目的探讨脑脊液负流量置换加鞘内注药治疗中晚期结核性脑膜炎（结脑）的临床疗效。方法92例中晚期结脑患者随机分为治疗组（47例）和对照组（45例），所有患者均采用3HRZE（S）／9HRE方案抗结核治疗，治疗组患者同时采用脑脊液负流量置换加鞘内注药，对比2组疗效。结果治疗2个月末、6个月末、12个月末时治疗组脑脊液蛋白水平、白细胞数和脑脊液压力下降速度等方面均明显低于对照组（P〈0．01）。治疗2、6、12个月末时治疗组总有效率分别为87．23％、89．36％、91．49％，对照组总有效率分别为60％、64．44％、77．78％，两组总疗效比较差异有显著性（P〈0．01）。未发现与脑脊液负流量置换加鞘内注药相关的并发症。结论脑脊液负流量置换加鞘内注药治疗中晚期结脑效果较好，值得在临床上推广使用。
Objective To explore the long-term curative effect of negative flow of substituting cerebrospiral fluid combined with intrathecal injection for tuberculous cephalomeningitis in advanced stage. Methods 92 cases of tuberculous cephalomeningitis in middle and late stage were randomly divided into the treatment group （47 cases） and the control group （45 cases）. Both groups received the 3HRZE（S）/ 9HRE treatment, while the treatment group was, in addition, treated by negative flow of substituting cerebrospiral fluid combined with intrathecal injection. Comparison was made between the two groups. Result By the end of 2 months, 6 months and 12 months, there were significant difference between the two groups in the reduction rate of protein, leukocyte and the pressure of cerebrospiral fluid（ P 〈0.01 ）. By the end of 2 months, 6 months and 12 months, the total effective rate was 87.23%, 89.36% and 91. 49% in the treatment group, while 60%, 64.44% and 77.78% in the control group, showing a significant difference between the two groups （P 〈 0.01 ）. No complications and obvious adverse reactions were observed in the process of substituting cerebrospiral fluid and intrathecal injection. Conclusion Treatment for tuberculous cephalomeningitis in advanced stage by negative flow of substituting cerebrospiral fluid combined with intrathecal injection is safer and more effective than simple chemotherapy, thus is worthily recommended in clinical application.
出处
《医学新知》
CAS
2009年第5期281-283,286,共4页
New Medicine
关键词
结脑
脑脊液
置换
鞘内注药
tuberculous Cephalomeningitis
cerebrospiral fluid
substitution
intrathecal injection
