标题：微量泵持续输注与间断输注美罗培南治疗脑肿瘤术后颅内感染的效果比较

      作者：张泽波 1，陈莉华 1，唐洲平 2    (1.孝感市中心医院感染科，湖北 孝感 432000；2.华中科技大学同济医学院附属同济医院神经内科，湖北 武汉 430000)

      卷次： 2017年28卷12期

      【摘要】 目的 探讨微量泵持续输注美罗培南治疗脑肿瘤术后颅内感染的情况。方法 选取2013年4月至2016年 4月在我院治疗的脑肿瘤术后颅内感染患者 102例，采用随机数表法将患者分为微量泵静脉持续输注组和间断输注组，每组 51例，两组均输注美罗培南。观察两组治疗疗效、症状缓解、治疗疗程、住院天数及脑脊液常规指标 (葡萄糖、蛋白和白细胞)。结果 持续输注组治疗总有效率为 88.24%，显著优于间断输注组的78.43%，差异有统计学意义 (P<0.05)；持续输注组治疗后脑脊液中葡萄糖为(4.53±1.04) mmol/L，明显高于间断输注组的(3.13±1.1) mmol/L，差异有统计学意义(P<0.05)，而蛋白和白细胞分别为(0.43±0.12) mg/L和(0.62±0.10)×106/L，明显低于间断输注组的(0.92±0.11) mg/L和(1.22±0.14)×106/L，差异均有统计学意义(P<0.05)；持续输注组患者治疗后3 d体温下降、头痛缓解和脑脊液糖定量正常的比例分别为70.59%、68.63%和58.82%，均明显高于间断输注组的50.98%、49.02%和 35.29%，差异有统计学意义(P<0.05)；持续输注组治疗疗程和住院天数分别为(9.81±2.41) d和(16.20±3.17) d，明显短于间断输注组的(12.04±1.54) d和(21.81±2.32) d，差异比较有统计学意义(P<0.05)。结论 微量泵持续输注美罗培南治疗脑肿瘤术后颅内感染的效果较好，其能缩短药物治疗的疗程以及住院时间，改善患者脑脊液常规指标，患者症状明显缓解，值得临床推广使用。
      【关键词】 美罗培南；微量泵；静脉持续输注；颅内感染；效果
      【中图分类号】 R739.41 【文献标识码】 A 【文章编号】 1003—6350（2017）12—1938—03

Effect comparison of continuous and intermittent micropump infusion of meropenem in the treatment of patientswith intracranial infection after brain tumor operation.
ZHANG Ze-bo 1, CHEN Li-hua 1, TANG Zhou-ping 2.1. Department of Infectious Diseases, Xiaogan Center Hospital, Xiaogan 432000, Hubei, CHINA; 2. Department ofNeurology, Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430000, Hubei, CHINA
【Abstract】 Objective To investigate effect of continuous micropump infusion of meropenem in the treatmentof patients with intracranial infection after brain tumor operation. Methods A total of 102 patients with intracranial in-fection after brain tumor surgery in our hospital from April 2013 to April 2016 were selected. Accroding to the randomnumber table, they were divided into continuous infusion group and intermittent infusion group, with 51 cases in eachgroup. The two groups were infused of meropenem. The therapeutic effect, symptom relief, the course of treatment, thelength of hospital stay and the routine indexes of cerebrospinal fluid (glucose, protein and white blood cell) were observedbetween the two groups. Results The total effective rate were 88.24% in continuous infusion group, which was signfi-cantly higher than 78.43% in intermittent infusion group (P<0.05). The glucose in cerebrospinal fluid after treatment was(4.53±1.04) mmol/L in continuous infusion group, which was significantly higher than (3.13±1.1) mmol/L in intermittentinfusion group (P<0.05). The protein and white blood cells were respectively (0.43±0.12) mg/L and (0.62±0.10)×106/Lof continuous infusion group, which were significantly lower than (0.92±0.11) mg/L and (1.22±0.14)×106/L of intermit-tent infusion group (P<0.05). After treatment 3 d, the proportion of body temperature decrease, headache remission andnormal cerebrospinal fluid glucose quantification were respectively 70.59%, 68.63% and 58.82% in continuous infu-sion group, which were significantly higher than 50.98%, 49.02% and 35.29% in the intermittent infusion group (P<0.05). The treatment course and hospital days were (9.81±2.41) d and (16.20±3.17) d in continuous infusion group,which were significantly shorter than (12.04±1.54) d and (21.81±2.32) d in the intermittent infusion group (P<0.05).Conclusion Continuous micropump infusion of meropenem has better effect in the treatment of patients with intracra-nial infection after brain tumor operation, which can shorten the course of drug treatment and hospital stay, improve thepatient's cerebrospinal fluid routine indicators, and relieve the symptoms of patients. It is worthy of clinical application.
      【Key words】 Meropenem; Micropump; Intravenous continuous infusion; Intracranial infection; Effect·论 著·doi:10.3969/j.issn.1003-6350.2017.12.015基金项目：国家自然科学基金(编号：30570628、30770751)