脑脊液冲洗置换注药联合治疗结核性脑膜炎82例临床研究.DOCVIP

临床医学论文-脑脊液冲洗置换注药联合治疗结核性脑膜炎82例临床研究 ?????????? 作者：蒋萍萍，纪发敬，秦保健，袁淑青，杨福纪，陈新平 【关键词】? 脑膜炎,结核；脑脊液冲洗置换；注药 　　［摘要］? 目的? 探讨脑脊液冲洗置换注药联合治疗结核性脑膜炎的临床价值。方法? 82例结核性脑膜炎患者随机分组后，将脑脊液冲洗置换注药联合治疗组与非联合治疗组临床疗效比较。结果? 脑脊液冲洗置换注药联合治疗组疗效和预后明显优于非联合治疗组，住院时间明显短于非联合治疗组。结论? 在全身系统化疗基础上行脑脊液冲洗置换注药联合治疗可明显提高结核性脑膜炎疗效、改善其预后、缩短住院时间、节省住院治疗费用，具有明显的社会效益，值得临床推广。 　　［关键词］? 脑膜炎，结核；脑脊液冲洗置换；注药??? 　　Clinical analysis of cerebrospinal fluid washreplacement combined with intrathecal injection on treating tuberculous meningitis:a report of 82 cases 　　［Abstract］? Objective? To explore the clinical effects of cerebrospinal fluid washreplacement combined with intrathecal injection on treating tuberculous meningitis.Methods? 82 patients with tuberculous meningitis were randomly divided into two treatment groups:the cerebrospinal fluid washreplacement combined with intrathecal injection group and the cerebrospinal fluid washreplacement only group.A comparative study of the efficacy between the two groups had been done.Results?In the cerebrospinal fluid washreplacement combined with intrathecal injection group,the effect and prognosis were much better than noncombined treatment group,and the inhospital time were also shorter than noncombined group.Conclusion?On the basis of given traditional treatment of tubercular meningitis,the cerebrospinal fluid washreplacement combined with intrathecal injections can significantly improve the effect and prognosis,and can reduce the inhospital time,and also can decrease the spending of inpatient treatment. 　　［Key words］? meningitis,tuberculous;cerebrospinal fluid washreplacement;intrathecal injection 　　结核性脑膜炎(简称结脑）是中枢神经系统感染性疾病中，诊断较困难、治疗较棘手、并发症多的疾病。以往治疗均为全身系统化疗，对重症患者经全身化疗后症状和脑脊液继续恶化或有椎管梗阻趋势者才行鞘内注射治疗。我科自1999年以来选择首发住院患者82例；其中41例入院后及早在全身系统化疗基础上行脑脊液冲洗置换注药联合治疗，取得良好疗效，我们将脑脊液冲洗置换注药联合治疗组与单纯全身系统抗痨治疗组进行对照，研究脑脊液冲洗置换注药联合治疗在结脑中的治疗价值。 　　1? 临床资料 　　1.1? 一般资料? 入选82例结脑患者均为我院1999年1月～2003年11月之间住院患者，均为首次发病，均经询问病史、体检、脑脊液、X线、头颅CT检查后确诊。将入选病例随机分为两组：脑脊液冲洗置换注药联合治疗组（简称治疗组）和常规药物治疗组（简称对照组），治疗组41例，男23例，女18例，年龄16～60岁，平