脑室内注射万古霉素治疗与脑脊液分流和引流相关的脑室炎。
Intraventricular vancomycin in the treatment of ventriculitis associated with cerebrospinal fluid shunting and drainage.
作者信息
Bayston R, Hart C A, Barnicoat M
机构信息
Institute of Child Health, London, UK.
出版信息
J Neurol Neurosurg Psychiatry. 1987 Nov;50(11):1419-23. doi: 10.1136/jnnp.50.11.1419.
Abstract
The results of treatment of 50 cases of ventriculitis associated with the use of cerebrospinal fluid shunts or external ventricular drains, and treated with intraventricular vancomycin, are reported. While the overall cure rate was 66% with four cases lost to follow-up, in those cases where treatment involved shunt removal, 20 mg vancomycin daily intraventricularly, and another appropriate systemic antibiotic, 22 of 24 cases were cured with two cases lost to follow-up. In those cases where the shunt was left in during treatment, results were poor and revision for blockage of the distal catheter of ventriculoperitoneal shunts was required in 44% of these. All five patients whose ventriculitis followed external ventricular drainage were cured. Despite relatively high trough levels of vancomycin in the cerebrospinal fluid, no evidence of toxicity was seen.
摘要
本文报告了50例与脑脊液分流术或脑室外引流相关的脑室炎患者，采用脑室内注射万古霉素治疗的结果。在4例失访的情况下，总体治愈率为66%。在那些治疗包括移除分流管、每日脑室内注射20mg万古霉素以及另一种合适的全身用抗生素的病例中，24例中有22例治愈，2例失访。在那些治疗期间保留分流管的病例中，效果较差，其中44%的患者需要对脑室-腹腔分流管的远端导管堵塞进行修复。所有5例因脑室外引流后发生脑室炎的患者均治愈。尽管脑脊液中万古霉素的谷浓度相对较高，但未发现毒性证据。
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