Clinical efficacy of intrathecal injection of vancomycin and meropenem in the treatment of intracranial infection after surgery for severe traumatic brain injury
Objective To analyze the effect of intrathecal injection of vancomycin and meropenem in the treatment of intracranial infection after surgery for severe traumatic brain injury.Methods A total of 86 patients with intracranial infection after surgery for severe traumatic brain injury were selected as the study subjects.The patients were randomly divided into a study group and a conventional group,each consisting of 44 patients.The conventional group received intravenous infusion of vancomycin and meropenem,while the study group received intrathecal injection of vancomycin and meropenem.The clinical efficacy,incidence of adverse reactions,complications,cerebrospinal fluid indicators,serum inflammatory factors,intracranial pressure,time for symptom disappearance,cure time,and treatment cost of the two groups were compared.Results The total effective rate of the study group was 97.67%,which was higher than 81.40%of the conventional group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was 4.65%,which was lower than 20.93%in the conventional group,and the difference was statistically significant(P<0.05).The complication rate of the study group was 2.33%,which was lower than 16.28%of the conventional group,and the difference was statistically significant(P<0.05).The time for symptom disappearance,cure time and treatment cost in the study group were(6.06±1.14)d,(10.12±4.05)d and(1.64±0.73)ten thousand yuan,which were less than(10.15±1.94)d,(24.12±10.23)d and(2.85±1.24)ten thousand yuan in the conventional group.The difference was statistically significant(P<0.05).After treatment,the levels of C-reactive protein and interleukin-6 in the study group were(8.18±1.46)mg/L and(16.03±2.32)ng/L,which were lower than(13.15±1.84)mg/L and(20.93±2.79)ng/L in the conventional group,and the difference was statistically significant(P<0.05).After treatment,the intracranial pressure in the study groupwas(2.24±0.22)kPa,which was lower than(2.68±0.51)kPa in the conventional group,and the difference was statistically significant(P<0.05).After treatment,the study group had higher cerebrospinal fluid glucose of(2.47±0.85)mmol/L than(1.78±0.46)mmol/L in the conventional group;the study group had white blood cell count of(355.60±280.26)×106/L and protein quantification of(1.36±1.05)g/L,which were lower than(601.60±312.07)×106/L and(2.28±1.06)g/L in the conventional group;the difference was statistically significant(P<0.05).Conclusion Intrathecal injection of vancomycin and meropenem for patients with intracranial infection after surgery for severe traumatic brain injury can reduce serum inflammatory response,improve cerebrospinal fluid indicators,reduce complications,and reduce intracranial pressure in patients.The therapeutic effect is significant,and the clinical application value is high.
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