CAJ | 학술논문

目的：探讨脑脊液置换术联合鞘内注射治疗老年中晚期结核性脑膜炎的效果。方法老年中晚期结核性脑膜炎患者200例根据随机抽签法分为治疗组与对照组各100例，对照组给予传统药物治疗，治疗组在此基础上加用脑脊液置换术联合鞘内注射治疗，观察期均为8周。结果治疗组有效率为95.0％，对照组为80.0％，治疗组明显高于对照组（ P＜0.05）。2组治疗前脑脊液白细胞数及蛋白值对比差异无统计学意义（P＜0.05），治疗后均呈明显下降趋势，治疗后治疗组的脑脊液白细胞数及蛋白值明显低于对照组（ P＜0.05）。治疗组的意识清醒时间、头痛缓解时间与脑脊液压力恢复时间明显低于对照组，差异有统计学意义（ P＜0.05）。2组治疗期间的医源性感染、药物性蛛网膜炎、脑疝等不良反应发生情况对比差异无统计学意义（ P＞0.05）。结论脑脊液置换术联合鞘内注射为治疗老年中晚期结核性脑膜炎提供了一种安全、有效的新途径，其作用的发挥与降低脑脊液白细胞数及蛋白质有关。
목적：탐토뇌척액치환술연합초내주사치료노년중만기결핵성뇌막염적효과。방법노년중만기결핵성뇌막염환자200례근거수궤추첨법분위치료조여대조조각100례，대조조급여전통약물치료，치료조재차기출상가용뇌척액치환술연합초내주사치료，관찰기균위8주。결과치료조유효솔위95.0％，대조조위80.0％，치료조명현고우대조조（ P＜0.05）。2조치료전뇌척액백세포수급단백치대비차이무통계학의의（P＜0.05），치료후균정명현하강추세，치료후치료조적뇌척액백세포수급단백치명현저우대조조（ P＜0.05）。치료조적의식청성시간、두통완해시간여뇌척액압력회복시간명현저우대조조，차이유통계학의의（ P＜0.05）。2조치료기간적의원성감염、약물성주망막염、뇌산등불량반응발생정황대비차이무통계학의의（ P＞0.05）。결론뇌척액치환술연합초내주사위치료노년중만기결핵성뇌막염제공료일충안전、유효적신도경，기작용적발휘여강저뇌척액백세포수급단백질유관。
Objective To investigate the effects of cerebrospinal fluid replacement therapy combined with intrathecal injec‐tion on elderly patients with advanced tuberculous meningitis.Methods 200 elderly patients with tuberculous meningitis were equally divided into treatment group and control group by random draw method ,patients in the control group received conven‐tional therapy ,and the treatment group received the cerebrospinal fluid replacement therapy combined with intrathecal injection based on the control group ,and the course of treatment continued eight weeks.Results The effective rate of 95.0% in the treatment group was significantly higher than 80.0% in the control group (P<0.05). The leukocyte count of cerebrospinal fluid and protein values showed no statistical difference between two groups before treatment ,while which obviously decreased after treatment in two groups ,and the treatment group reduced more remarkable than the control group (P<0.05). The re‐covery time of consciousness ,headache and cerebrospinal fluid pressure in the treatment group were significantly lower than the that in control group ,the difference was statistically significant (P<0.05). The rates of iatrogenic infections ,drug‐induced arachnoiditis ,cerebral hernia and other adverse events showed no statistical difference between the two groups (P>0.05).Conclusion It is safe and effective for cerebrospinal fluid replacement therapy combined with intrathecal injection to treat ad‐vanced tuberculous meningitis ,and its function may be closely related to the reduction of the leukocyte count of cerebrospinal fluid and protein values.