Clinical research of lumbar puncture combined with intrathecal injection in treatment of intracranial infections after craniotomy

OBJECTIVE To explore the clinical efficacy of lumbar puncture combined with intrathecal injection in treatment of intracranial infections after craniotomy so as to provide reference for choosing the safe and effective antibiotics as well as the appropriate administration.METHODS A total of 60 cases of skull base fracture patients complicated with cerebrospinal fluid leakage,who were complicated with intracranial infections after craniotomy,were enrolled in the study and randomly divided into the observation group and the control group,with 30 cases in each.The patients of the control group were treated by using vancomycin infusion therapy,and the observation group was treated by using lumbar puncture combined with intrathecal vancomycin injection therapy,then the CSF biochemical markers were detected respectively on 1 day,3 days,or 5 days after the treatment,and the clinical efficacy was evaluated 5 days after treatment.RESULTS The total effective rate was 93.3% in the observation group,63.3% in the control group,the chi-square test showed that the difference in the total effective rate between the two groups was statistically significant(χ2=7.954,P0.05).the WBC counts on the 1 day,three days,or five days after the treatment were(117.72±39.24)×106/L,(89.12±28.29)×106/L,and(69.06±24.23)×106/L,respectively in the observation group,and the protein levels on the 1 day,three days,or five days after the treatment were(0.34±0.11),(0.21±0.07),and(0.12±0.04)g/L,respectively in the observation group,as the duration of treatment prolonged,the WBC count and the protein level showed a downward tend,while an upward trend in the control group,as compared with the level after prior treatment,the difference was statistically significant(P0.05).CONCLUSION Lumbar puncture combined with intrathecal vancomycin injection therapy is a safe,effective,and simple method for the treatment of intracranial infections in the skull base fracture patients complicated with cerebrospinal fluid leakage after the craniotomy,and it is worthy of clinical application.