Objective To observe the efficacy of intrathecal injection combined with intravenous drip of meropenem in the treatment of patients with intracranial infection after glioma surgery.
Methods A total of 102 patients with intracranial infection after glioma surgery were randomly divided into control group and observation group, with 51 cases in each group. Both groups were treated with intravenous drip of ceftriaxone and lumbar cistern catheterization for cerebrospinal fluid drainage. On this basis, the control group received intravenous drip of meropenem, while the observation group received intrathecal injection combined with intravenous drip of meropenem. Therapeutic effect, the symptom relief rate and medication time after 3 days of treatment, the inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) in cerebrospinal fluid, infection indicatorsinterferon-γ (IFN-γ), T cell immunoglobulin mucin molecule-3 (Tim-3) and soluble intercellular adhesion molecule-1 (sICAM-1), cerebrospinal fluid indicators white blood cell count, chloride and glucose before and after treatment as well as incidence of adverse reactions were compared between two groups.
Results The total effective rate of the observation group was 92.16%, which was significantly higher than 76.47% of the control group (P < 0.05). After 3 days of treatment, the relief rate of headache, decrease rate of body temperature and normal rate of cerebrospinal fluid glucose quantification in the observation group were significantly higher than those in the control group, while the medication time was significantly shorter than that in the control group (P < 0.05). After treatment, the IL-6, TNF-α and CRP levels in the cerebrospinal fluid were significantly lower than those before treatment in both groups, and the levels of indexes in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the IFN-γ, Tim-3 and sICAM-1 levels in the cerebrospinal fluid were significantly lower than those before treatment, and the levels of indexes in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the white blood cell count in both groups was significantly lower than that before treatment, while the levels of chloride and glucose in the cerebrospinal fluid were significantly higher than those before treatment, and the white blood cell count in the observation group was significantly lower than that in the control group, while the levels of chloride and glucose in the cerebrospinal fluid were significantly higher than those in the control group (P < 0.05). The incidence of adverse reactions was 7.84% in the observation group, which showed no significant difference when compared to 11.76% in the control group (P > 0.05). At the follow up of 6 months, 2 cases were lost in the observation group and 3 cases were lost in the control group; the overall 6-month survival rate of the observation group was 91.84% (45/49), which showed no significant difference when compared to 91.67% (44/48) in the control group (P > 0.05).
Conclusion Intrathecal injection combined with intravenous drip of meropenem can reduce the treatment time and dosage of patients with intracranial infection after glioma surgery, quickly alleviate symptoms, improve postoperative related indicators, reduce levels of inflammatory factors, promote recovery, and safety is relatively high.
DownLoad: