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目的分析神经外科重症加强护理病房(ICU)耐药鲍曼不动杆菌颅内感染治疗方法及效果。方法给予14例神经外科ICU耐药鲍曼不动杆菌颅内感染患者对症治疗,观察治疗效果。结果 14例患者经过治疗后,有效控制感染12例,转院1例,死亡1例。脑脊液连续培养无鲍曼不动杆菌生长。治疗前,患者体温(38.9±1.1)℃、白细胞计数(24.1±3.5)10~9/L;治疗后,体温(37.2±0.4)℃,白细胞计数(10.4±1.8)10~9/L。治疗前后比较差异具有在统计学意义(P<0.05)。治疗前,患者各项脑脊液生化指标:氯化物(84.9±10.7)mmol/L、葡萄糖(1.8±0.5)mmol/L、蛋白(0.9±0.6)g/L、细胞数(58.7±3.6)个/μl;治疗后,氯化物(103.4±8.1)mmol/L、葡萄糖(2.5±1.3)mmol/L、蛋白(0.5±0.2)g/L、细胞数(13.4±2.7)个/μl。治疗前后比较差异具有统计学意义(P<0.05)。结论耐药鲍曼不动杆菌对美罗培南和多粘菌素敏感,临床合用这两种药物治疗,具有良好治疗效果。
Objective To analyze the method and effect of intracranial infection of Acinetobacter baumannii in intensive care unit (ICU) of neurosurgical department. Methods 14 cases of neurosurgical ICU-resistant Acinetobacter baumannii intracranial infection symptomatic treatment, to observe the therapeutic effect. Results After the treatment of 14 patients, 12 cases were effectively controlled, 1 case transferred to hospital and 1 patient died. Continuous culture of cerebrospinal fluid without Acinetobacter baumannii growth. Before treatment, the body temperature (38.9 ± 1.1) ℃ and the white blood cell count (24.1 ± 3.5) were 10 ~ 9 / L. After treatment, body temperature (37.2 ± 0.4) ℃ and white blood cell count (10.4 ± 1.8) 10 ~ 9 / L. The difference between before and after treatment was statistically significant (P <0.05). Before treatment, the biochemical parameters of cerebrospinal fluid (CSF) were chloride (84.9 ± 10.7 mmol / L, glucose 1.8 ± 0.5 mmol / L, protein 0.9 ± 0.6 g / L, cell count 58.7 ± 3.6) μL. The chloride (103.4 ± 8.1) mmol / L, glucose (2.5 ± 1.3) mmol / L, protein (0.5 ± 0.2) g / L and cell number (13.4 ± 2.7) / μl after treatment. The difference between before and after treatment was statistically significant (P <0.05). Conclusion Acinetobacter baumannii is sensitive to meropenem and polymyxin, and it has good curative effect in both clinical and clinical treatment.