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目的:探讨颅内感染患者鞘内注射万古霉素的适宜给药方案。方法:通过测定患者脑脊液的万古霉素浓度,对1例颅内感染患者进行鞘内注射万古霉素给药方案的调整。结果:该脑膜炎患者采用静脉使用抗菌药物联合鞘内万古霉素的治疗方案,成功地治疗了颅内感染,且无不良反应发生。患者每日或隔日鞘内注射万古霉素5~15mg,脑脊液谷浓度为9.45~105.34μg·mL~(-1),血中浓度始终<0.24μg·mL~(-1)。结论:患者脑脊液中万古霉素的代谢情况受到给药方案、患者状态等多因素的影响,脑脊液的药物监测可以为鞘内注射的给药剂量调整提供依据,协助医师制订个体化治疗方案。
Objective: To investigate the appropriate dosing regimen of intrathecal injection of vancomycin in patients with intracranial infection. Methods: One patient with intracranial infection was given intrathecal administration of vancomycin by adjusting the concentration of vancomycin in cerebrospinal fluid of patients. Results: The patients with meningitis were treated with intravenous antibiotics combined with intrathecal vancomycin, which successfully treated intracranial infection without any adverse reactions. Vancomycin 5-15mg, cerebrospinal fluid trough concentration 9.45-105.34μg · mL -1, the blood concentration always <0.24μg · mL -1. Conclusion: The metabolism of vancomycin in CSF of cerebrospinal fluid is affected by many factors such as the dosage regimen and patient status. The drug monitoring of cerebrospinal fluid can provide a basis for dosage adjustment for intrathecal injection and help physicians formulate individualized treatment plans.