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目的探讨脑脊液置换联合鞘内注射药物治疗中晚期儿童结核性脑膜炎的疗效。方法选择2005年1月-2010年4月本院收治住院的64例中晚期结核性脑膜炎患儿,随机分为治疗组和对照组各32例。对照组予常规抗结核药物治疗,治疗组在常规抗结核药物治疗基础上行脑脊液置换,并鞘内注射抗结核药物,治疗8周后对比2组治疗效果。结果治疗组治愈24例,好转5例,无效2例,死亡1例,总有效率为90.6%;对照组治愈17例,好转5例,无效7例,死亡2例,总有效率为68.8%。2组总有效率比较差异有统计学意义(χ2=4.729,P<0.05)。结论脑脊液置换联合鞘内射注药物治疗中晚期儿童结核性脑膜炎疗效好,且不良反应少。
Objective To investigate the curative effect of cerebrospinal fluid replacement combined with intrathecal injection on tuberculous meningitis in children with advanced stage. Methods Sixty - four children with intermediate and advanced stage tuberculous meningitis hospitalized in our hospital from January 2005 to April 2010 were randomly divided into treatment group (32 cases) and control group (32 cases). The control group was treated with conventional antituberculosis drugs. The treatment group was treated with cerebrospinal fluid replacement based on the conventional antitubercular drugs and intrathecally injected with anti-tuberculosis drugs. The therapeutic effects were compared between the two groups after 8 weeks of treatment. Results In the treatment group, 24 cases were cured, 5 cases were improved, 2 cases were ineffective and 1 case died. The total effective rate was 90.6%. In the control group, 17 cases were cured, 5 cases improved, 7 cases were ineffective and 2 cases died. The total effective rate was 68.8% . The total effective rate in the two groups was significantly different (χ2 = 4.729, P <0.05). Conclusions Cerebrospinal fluid replacement combined with intrathecal injection is effective in treating children with tuberculous meningitis in middle and late stages with less adverse reactions.