【摘要】 目的探讨改良腰大池外引流治疗重症结核性脑膜炎的疗效与安全性。方法回顾性分析39例重症结核性脑膜炎病例资料。治疗组18例,对照组21例。在化疗方案HRZE基础上,治疗组行皮下潜行腰大池外引流、鞘内注药治疗;对照组间断腰椎穿刺、鞘内注药(2次/周)。比较两组病人意识状态、GCS评分,脑脊液实验室检查指标变化。结果治疗组治疗后病人意识状态、GCS评分、脑脊液实验室检测指标及痊愈率较对照组统计学差异显著(P<0.05)。结论皮下潜行腰大池持续外引流并鞘内注药治疗结核性脑膜炎安全而有效。在内科抗结核治疗基础上,联合皮下潜行腰大池持续外引流并鞘内注药治疗重症结核性脑膜炎,临床疗效优于传统治疗方案。更多还原

【Abstract】 Objective To investigate therapeutic efficacy and safety of improved lumbar drainage treatment of severe tuberculous meningitis(STM). Methods The clinical data of 39 STM patients were analyzed retrospectively. There were 18 patients in treatment group and 21 in control group. The chemotherapy program was HRZE. In the same time, the subcutaneous lumbar drainage and intrathecal injection were performed in the treatment group and lumbar puncture and intrathecal injection in the control group(2 times a week). The consciousness, GCS score and biochemical indexes of cerebrospinal fluid were compared between the two groups.Results The consciousness, GCS score, biochemical indexes of cerebrospinal fluid and complete cure rate of the patients were more favorable in treatment group than in the control group(P < 0.05). Conclusions Subcutaneous lumbar drainage and intrathecal injection treatment is safe and effective for tuberculous meningitis. The subcutaneous lumbar drainage combined with intrathecal injection based on anti-tuberculosis is superior to traditional treatment methods for STM.更多还原