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对细菌性脑膜炎的处理,虽因细菌抗药性问题的出现使其起着周期性变化,但抗菌和支持疗法已经标准化多年。目前,对许多生理和代谢失常引起的脑损害尚无理想的治疗方法。本文扼要介绍细菌性脑膜炎的若干并发症及其处理问题。颅内压增高:细菌性脑膜炎可引起颅内压和脑脊液容量增加,并使脑灌注减少。主要的处理方法有3种:(1)对一些特殊的颅内感染(如结核性脑膜炎和感染性脑脊液分流),可通过脑室导管脑外引流来减少脑脊液的容量,但此法不用于一般脑膜炎病人。(2)促使病人过度换气,诱导低碳酸血症,使颅内压降低到≤20mmHg,从而减少脑血容量。(3)对外伤或恶性肿瘤所致
Treatment of bacterial meningitis, though cyclical in nature due to bacterial resistance issues, has been standardized for many years. At present, there is no ideal treatment for many brain damage caused by physiological and metabolic disorders. This article briefly describes some of the complications of bacterial meningitis and its handling issues. Increased intracranial pressure: bacterial meningitis can cause increased intracranial pressure and cerebrospinal fluid volume, and decreased cerebral perfusion. There are three main treatments: (1) For some special intracranial infections (such as tuberculous meningitis and infectious cerebrospinal fluid shunt), cerebrospinal fluid volume can be reduced by intraventricular catheter drainage outside the brain, but this method is not used in general Meningitis patients. (2) to promote the patient hyperventilation, hypocapnia induced to reduce intracranial pressure to ≤ 20mmHg, thereby reducing cerebral blood volume. (3) caused by trauma or malignancy