河北医科大学学报

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鞘内注射异烟肼加地塞米松同时等量生理盐水置换治疗结核性脑膜炎的价值

  

  1. 1.河北省胸科医院院办室,河北 石家庄 050041;2.河北省胸科医院神经内科,河北 石家庄 050041;
    3.河北省胸科医院妇产科,河北 石家庄 050041;4.河北省胸科医院影像科,河北 石家庄  050041
  • 出版日期:2020-01-25 发布日期:2020-02-25
  • 作者简介:白洪忠(1975-),男,河北沧州人,河北省胸科医院副主任医师,医学学士,从事医学影像诊断研究。
  • 基金资助:
    河北省医学科学研究重点课题(20150139)

Value of intrathecal isoniazid and dexamethasone combined with equal amount of normal saline replacement in the treatment of tuberculous meningitis#br#

  1. 1.President′s Office, Hebei Chest Hospital, Shijiazhuang 050041, China; 2.Department of Neurology,
    Hebei Chest Hospital, Shijiazhuang 050041, China; 3.Department of Obstetrics and Gynecology,
    Hebei Chest Hospital, Shijiazhuang 050041, China; 4.Department of Imaging,
    Hebei Chest Hospital, Shijiazhuang 050041, China
  • Online:2020-01-25 Published:2020-02-25

摘要: [摘要]
目的  探讨鞘内注射异烟肼加地塞米松同时等量生理盐水置换治疗结核性脑膜炎的价值。
方法  将结核性脑膜炎患者78例随机分为对照组(鞘内注射异烟肼加地塞米松治疗)和观察组(在对照组基础上联合等量生理盐水置换治疗),比较2组治疗效果。
结果  治疗后,2组脑脊液中蛋白、葡萄糖、细胞计数含量均较治疗前降低,观察组脑脊液氯化物含量较治疗前降低(P<0.05)。治疗后,观察组脑脊液中蛋白、葡萄糖、细胞计数和氯化物含量均较对照组降低(P<0.05)。观察组总有效率高于对照组(P<0.05)。观察组药物不良反应率低于对照组(P<0.05)。观察组头痛颈强消失、脑脊液压力恢复、发热消失、呕吐消失、昏迷恢复、脑脊液蛋白含量恢复、脑脊液细胞含量恢复时间及住院时间均短于对照组(P<0.05)。
结论  对结核性脑膜炎患者采用鞘内注射异烟肼加地塞米松同时等量生理盐水置换治疗,临床治疗效果明确,临床指标、症状明显改善,在确保治疗安全的同时缩短了住院时间,为早期康复提供了保障。

关键词: 结核, 脑膜, 异烟肼, 地塞米松, 生理盐水

Abstract: [Abstract]Objective〖HTSS〗To analyze the value of intrathecal injection of isoniazid plus dexamethasone combined with saline replacement in the treatment of tuberculous meningitis.
Methods〖HTSS〗A total of 78 patients with tuberculous meningitis were selected. They were randomly divided into reference group(intrathecal injection of isoniazid plus dexamethasone) and observation group(control group combined with equal amount of normal saline replacement treatment). The therapeutic effects of the two groups were compared.
Results〖HTSS〗After treatment, content of protein, glucose and cell count in cerebrospinal fluid(CSF) of the two groups were lower than that before treatment, and content of chloride in CSF of the observation group was lower than that before treatment(P<0.05). After treatment, contents of protein, glucose, cell count and chloride in CSF of the observation group were all lower than that of control group(P<0.05). The total effective rate of observation group was higher than that of control group(P<0.05). The adverse drug reaction rate of observation group was lower than that of control group(P<0.05). The recovery time of headache and neck strength, CSF pressure, fever, vomiting, coma, CSF protein, CSF cell and hospitalization in the observation group were significantly shorter than those in control group(P<0.05).
Conclusion〖HTSS〗The treatment of tuberculous meningitis by intrathecal injection of isoniazid plus dexamethasone and replacement with equal amount of normal saline has clear clinical effect, obvious improvement of clinical indicators and symptoms, ensuring the safety of treatment, shortening the length of stay and providing guarantee for early rehabilitation.

Key words: tuberculosis, meninges, isoniazid, dexamethasone, normal saline