目的 评价静脉滴注(IV)联合鞘内/脑室内注射(ITH/IVT)多粘菌素治疗颅内多重耐药菌感染的有效性及安全性.方法 计算机检索万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库、Pubmed、Embase、ScienceDirect及Cochrane Library,筛选2023 年1 月前有关IV+ITH/IVT多粘菌素治疗颅内多重耐药菌感染的队列研究.采用RevMan 5.4 软件进行Meta分析.结果 最终纳入 9 项回顾性临床研究.IV+ITH/IVT组病死率显著低于IV组(OR =0.19,95%CI:0.11～0.35,P＜0.01).IV+ITH/IVT组与IV组ICU住院天数(OR =-2.32,95%CI:-23.59～18.89,P =0.83)及不良反应率(OR =0.93,95%CI:0.26～3.38,P =0.91)差异无统计学意义.结论 IV+ITH/IVT多粘菌素治疗颅内多重耐药菌感染可以显著降低患者病死率,且不显著增加不良反应.
Objective Evaluation of the efficacy and safety of intravenous(IV)combined with intrathecal/intraventricular injection(ITH/IVT)of polymyxin against intracranial infection with multidrug-resistant bacteria.Methods The databases,including Wanfang,VIP,Chinese Biomedical Literature,Pubmed,Embase,ScienceDirect,and Cochrane Library were searched,case-control studies on IV+ITH/IVT polymyxin against intracranial infection with multidrug-resistant bacteria by January 2023 were screen.RevMan 5.4 software was used for meta-analysis.Results A total of 9 retrospective studies were included.The fatality rate in IV+ITH/IVT polymyxin group was significantly lower than that in IV group(OR =0.19,95%CI:0.11-0.35,P＜0.01).There was no significant difference in ICU hospitalization days(OR =-2.32,95%CI:-23.59-18.89,P =0.83)and adverse reaction rate(OR =0.93,95%CI:0.26-3.38,P =0.91)between IV+ITH/IVT group and IV group.Conclusion IV+ITH/IVT polymyxin in treating the intracranial infection with multidrug-resistant bacteria can significantly reduce fatality rate,and does not significantly increase adverse reactions.
周益毅;龙勇;谢尊椿;王联群;洪道俊
330006 南昌大学江西医学院第一附属医院神经内科
临床医学
多粘菌素;颅内感染;鞘内注射;脑室内注射;Meta分析
polymyxin;encephalitis;intrathecal injection;intraventricular injection;Meta analysis
《临床神经病学杂志》 2024 (001)
15-19 / 5
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