脑脊液置换联合鞘内注药治疗结核性脑膜炎的临床观察.DOCVIP

临床医学论文-脑脊液置换联合鞘内注药治疗结核性脑膜炎的临床观察 ???????????? 作者：陈艺坛，黄圣排，潘云虎 【摘要】? 目的 探讨脑脊液置换联合鞘内注药治疗结核性脑膜炎的临床疗效。方法 采用脑脊液置换联合鞘内注药治疗结核性脑膜炎26例（治疗组）和常规抗结核药物及激素、脱水剂等治疗28例（对照组）。对两组的疗效和脑脊液压力、蛋白、糖、氯化物及细胞数恢复时间，住院天数进行比较。结果 治疗组治愈率（923%）与对照组治愈率（71．4%）相比有显著性差异（P＜0．05）；治疗组脑脊液蛋白、压力、糖、氯化物、细胞数恢复正常时间均较对照组明显缩短（P0.01）。结论 脑脊液置换联合鞘内注药可缓解结核性脑膜炎的症状，缩短疗程，该方法是治疗结核性脑膜炎的一种简单、有效、安全的方法。 【关键词】? 脑脊液置换；鞘内注药；结核性脑膜炎 　　Observation on Efficacy of Cerebrospinal Fluid Replacement Combined with Intrathecal Injection on Treating Tuberculous Meningitis 　　Abstract： Objective? To investigate the clinical effect of cerebrospinal fluld (CSF) replacement combined with intrathecal injection on treating tuberculous meningitis. Methods? A total of 26 cases of treatment group were treated with the method of CSF replacement combined with intrathecal injection and 28 cases of control group were treated with routine antituberculous drugs, hormone and dehydrant. The clinical effects were compared between the two groups, as well as the recovery time of CSF pressure, the levels of protein, glucose, chlorides, cells, and the time of hospitalization. R Results?The cure rate was 92.3% and 71.4% respectively in the treatment group and in the control group. There was a significan difference between the two groups (P0.05). The recovery time of CSF pressure was shorter in the treatment group than in the control group, as well as that of the levels of protein, glucose, chlorides and cells (P0.01).Conclusion?CSF replacement combined with intrathecal injection can relieve tuberculous meningitis symptoms, and it is a simple, effective and secure method. 　　Key? words： cerebrospinal fluid replacement; intrathecal injection; tuberculous meningitis ??? 2006年2月 第34卷 第1期临? 床 军 医 杂 志 (Clin J Med Offic) 结核性脑膜炎（简称结脑）临床症状严重、致残率和病死率高，治疗较困难，疗效欠佳。我院自1997年10月—2005年10月对26例结脑患者应用常规抗结核药物同时采用脑脊液置换联合鞘内注药治疗，并与同期收治的28例结脑患者进行对照，取得较好疗效，现报告如下。 　　1? 资料与方法 　　1．1? 一般资料? 　　54例均为住院初治患者，经病史、症状、体征、实验室检查、头颅 CT综合判定确诊为结脑，符合《新编结核病学》［1］结脑诊断标准。治疗组26例，男14例，女12例；年龄16~62岁，平均（34．5±3．2