摘要
Abstract
Objective To observe the clinical efficacy of cerebrospinal fluid replacement combined with intrathecal injection in treatment of middle and late tuberculous meningitis.Methods One hundred and twenty five patients with moderate to severe tuberculous meningitis in department of emergency,respiratory and tuberculosis medicine in Hebei Chest Hospital from January 2013 to July 2016 were selected and they were randomly divided into three groups: the control group was given conventional treatment,while the study 1 group was given subarachnoid injection treatment on the basis of control group,2 to 3 times/week,and the study 2 group was given cerebrospinal fluid replacement combined with subarachnoid injection treatment on the basis of control group,2 to 3 times/week.After 2 months of treatment,we observed the effect in 3 groups.Compared three groups of symptoms recovery time and recovery time of intracranial pressure and observed the treatment effect after two months treatment.Among the three groups,cells in the cerebrospinal fluid,protein,glucose,chloride were compared.DNA in cerebrospinal fluid of patients with positive rate and recovery of electroencephalogram were observed.Results The total efficiency rate of study 2 group was 95.24％,which was better than the control group(70.73％)and study 1 group(88.10％)(P<0.05).For the recovery time of clinical symptoms and intracranial pressure,there were statistically differences of the three groups(F=4.093,F=6.003,P=0.019,P=0.003).The change of CSF cell count,protein,glucose,chloride after two months of treatment were showed significantly differences among the three groups(F=3.407,F=9.429,F=8.599,F=14.950,P=0.036,P=0.000,P=0.000,P=0.000),positive rate of DNA in cerebrospinal fluid after treatment in study 2 group was statistically reduced(P=0.021).The EEG recovery in study 1 and 2 group were statistical significant(P=0.003,P=0.000).Conclusion Cerebrospinal fluid replacement combined with intrathecal injection in the treatment of severe tuberculous meningitis can promote symptom relief,improve the intracranial pressure and biochemical indices in the cerebrospinal fluid,and improve the patients' prognosis.关键词
结核性脑膜炎/脑脊液置换/鞘内注药/疗效Key words
Tuberculous meningitis/Cerebrospinal fluid replacement/Intrathecal drug delivery/Effect
