[1]原高明　孟晓峰　郭孝龙　崔　涛　程小兵　郝晓伟　李泓江　史保中.经不同途径应用万古霉素治疗兔细菌性脑室炎的效果[J].中国临床神经外科杂志,2019,(07):422-424.[doi:10.13798/j.issn.1009-153X.2019.07.014]
　YUAN Gao-ming,MENG Xiao-feng,GUO Xiao-long,et al.Effect of vancomycin administered via different ways on bacterial ventriculitis in adult rabbits[J].,2019,(07):422-424.[doi:10.13798/j.issn.1009-153X.2019.07.014]
点击复制

经不同途径应用万古霉素治疗兔细菌性脑室炎的效果()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年07期
页码:
422-424
栏目:
论著
出版日期:
2019-07-25

文章信息/Info

Title:
Effect of vancomycin administered via different ways on bacterial ventriculitis in adult rabbits
文章编号:
1009-153X（2019）07-0422-03
作者:
原高明　孟晓峰　郭孝龙　崔　涛　程小兵　郝晓伟　李泓江　史保中
471003 河南洛阳，河南科技大学第一附属医院神经外科（原高明、孟晓峰、郭孝龙、崔　涛、程小兵、郝晓伟、史保中）；200011 上海，上海交通大学医学院附属第九人民医院神经外科（李泓江）
Author(s):
YUAN Gao-ming1;  MENG Xiao-feng1;  GUO Xiao-long1;  CUI Tao1;  CHENG Xiao-bing1;  HAO Xiao-wei1;  LI Hong-Jiang2;  SHI Bao-zhong1. 1. Department of Neurosurgery;  the First Affiliated Hospital;  Henan University of Sciences and Technology;  Luoyang 471003;  China; 2. Department of Neurosurgery;  Shanghai Ninth People's Hospital;  Medical School;  Shanghai Jiaotong University;  Shanghai 200011;  China
1. Department of Neurosurgery, the First Affiliated Hospital, Henan University of Sciences and Technology, Luoyang 471003, China; 2. Department of Neurosurgery, Shanghai Ninth People's Hospital, Medical School, Shanghai Jiaotong University, Shanghai 200011, China
关键词:
细菌性脑室炎; 甘露醇; 万古霉素; 兔
Keywords:
Ventriculitis;  Vacomycin;  Administration;  Mannitol;  Rabbits
分类号:
R 742.6
DOI:
10.13798/j.issn.1009-153X.2019.07.014
文献标志码:
A
摘要:
目的 探讨经不同途径应用万古霉素治疗兔细菌性脑室炎的效果。方法 将新鲜配制的标准表皮葡萄球菌混悬液0.5 ml以0.1 ml/min的速度缓慢注入侧脑室将制作兔细菌性脑室炎模型。将50只细菌性脑室炎成年新西兰大白兔随机分为单纯静脉组（Ⅰ组，静脉注射万古霉素）、单纯动脉组（Ⅱ组，颈内动脉注射万古霉素）、联合静脉组（Ⅲ组，先静脉注射甘露醇，继而注射万古霉素）、联合动脉组（Ⅳ组，先颈内动脉注射甘露醇，继而注射万古霉素），对照组（Ⅴ组，静脉注射生理盐水），每组10只。所有动物均12 h给药一次，直至动物死亡，最多给药6次。结果 Ⅰ组、Ⅱ组给药后96 h内无动物死亡，Ⅲ组给药后72~96 h死亡5只，Ⅳ组给药后72~96 h死亡1只，Ⅴ组给药后24 h内全部死亡。首次给药后1 h，Ⅰ、Ⅱ、Ⅲ、Ⅳ组脑脊液万古霉素浓度分别为（40.02±0.07）μg/L、（89.11±0.19）μg/L、（69.02±0.17）μg/L、（118.13±0.31）μg/L；两两比较，均有统计学差异（P<0.05）。给药72 、96 h，Ⅳ组肛温、外周血白细胞数、脑脊液白细胞数均明显低于Ⅲ组（P<0.05）。结论 经颈内动脉联合应用甘露醇和万古霉素治疗细菌性脑室炎的效果优于单纯静脉或动脉注射万古霉素以及经静脉联合应用甘露醇和万古霉素的效果。
Abstract:
Objective To investigate the effect of vancomycin administered via different ways on bacterial ventriculitis in adult rabbits. Methods Fifty adult rabbits with bacterial ventriculitis established by injection of Staphylococcus epidermidis suspension into the cella lateralis of rabbits were randomly divided into 5 groups of 10 animals each, i.e. group Ⅰ in which the animals received intravenous injection of vacomycin, group Ⅱ in which the animals received intraarterial injection of vacomyin, group Ⅲ in which the animals received intravenous injection of vacomycin after the intravenous infusion of mannitol, group Ⅳ in which the animals received intraarterial injection of vacomycin after the intraarterial infusion of mannitol and group V in which the animals received intravenous injection of physiological saline. The treatment (once every 12 hours and total 6 times) began after blood and cerebrospinal fluid (CSF) samples were taken. The rectal temperature and rate of animal survival were observed in all the groups. The concentration of vancomycin in CSF was measured, and routine examinations of blood and CSF were performed in all the animals. Results The CSF concentration of vancomycin in group Ⅳ is the highest among these 5 groups after the first administration of vacomycin (P<0.05). The rate of animal survival was 90% (9/10) in group Ⅳ, it was 50%(5/10) in the group Ⅲ and all the animals dead in group Ⅰ, Ⅱ and Ⅴ 96 hours after the treatment. The rectal temperature and numbers of blood and CSF leukocytes were significantly lower in group Ⅳ than those in group Ⅲ 96 hours after the treatment (P<0.05). Conclusion It is suggested that the intraarterial injection of vacomycin after the intraarterial injection of mannitol may enhance the curative effects of the vacomycin on the bacterial ventriculitis compared to simple intraarterial injection or intravenous injection of the vacomycin after the intravenous injection of mannitol.

参考文献/References:

[1] Satyarthee GD. Expanding horizon of neuroendoscopic pro- cedure from endoscopic-assisted tumor resection, vascular surgery, and management of hydrocephalus to diagnostic and therapeutic management of pyogenic ventriculitis [J]. World Neurosurg, 2017, 104: 1024-1025. [2] 史保中，孟晓峰，崔　涛，等. 脑室-腹腔分流术后颅内感 染的外科处理（附12例报告）[J]. 中国临床神经外科杂 志，2007，12（12）：748-749. [3] 张伟俈. 动物模型与实验外科[J]. 中华实验外科杂志， 2003，20（4）：293-295. [4] 原高明，孟晓峰，郭孝龙，等. 兔细菌性脑室炎模型的建立 [J]. 中国临床神经外科杂志，2018，23（3）：173-175. [5] 黄继汉，黄晓晖，陈志扬，等. 药理试验中动物间和动物与 人体间的等效剂量换算[J]. 中国临床药理学与治疗学， 2004，9（9）：1069-1072. [6] Brouwer MC, Vand BD. Management of bacterial central nervous system infections[J]. Handb Clin Neurol, 2017, 140: 349-364. [7] Lesourd A, Magne N, Soares A, et al. Primary bacterial ven- triculitis in adults, an emergent diagnosis challenge: report of a meningoccal case and review of the literature [J]. BMC Infect Dis, 2018, 18(1): 226. [8] 孟　然，周　晋，王德生，等. 甘露醇暂时渗透性开放血脑 屏障的研究[J]. 中风与神经疾病杂志，2003，20：350-352. [9] 于世林. 高效液相色谱方法及应用[M]. 第2版. 北京：化 学工业出版社化学与应用化学出版中心，2005. 75-91. [10] Ng K, Mabasa VH, Chow I, et al. Systematic review of effi- cacy, pharmacokinetics, and administration of intraventri- cular vancomycin in adults [J]. Neurocrit Care, 2014, 20(1): 158-171. [11] Robertson FC, Lepard JR, Mekary RA, et al. Epidemiology of central nervous system infectious diseases: a meta- analysis and systematic review with implications for neuro- surgeons worldwide [J]. J Neurosurg, 2018, (5): 1-20.

相似文献/References:

[1]陈　进　徐绪卿　祝　斐　金卫星　路　遥.白蛋白联合呋塞米降低颅脑损伤患者颅内压的临床观察[J].中国临床神经外科杂志,2015,(12):757.[doi:10.13798/j.issn.1009-153X.2015.12.019]
[2]王　杰　王英皎.半量与全量甘露醇对留置针安全留置时间及无菌性静脉炎发生率的影响[J].中国临床神经外科杂志,2017,(01):50.[doi:10.13798/j.issn.1009-153X.2017.01.020]
[3]张禄波　傅继东　遇旭东　丁建军　李　磊　王克辉.颅内压监测在重型颅脑损伤病人甘露醇应用中的意义[J].中国临床神经外科杂志,2017,(05):334.[doi:10.13798/j.issn.1009-153X.2017.05.018]
[4]原高明　孟晓峰　郭孝龙　崔　涛　程小兵　郝晓伟　李泓江　史保中.兔细菌性脑室炎模型的建立[J].中国临床神经外科杂志,2018,(03):173.[doi:10.13798/j.issn.1009-153X.2018.03.011]
　YUAN Gao-ming,MENG Xiao-feng,GUO Xiao-long,et al.Establishment of bacterial ventriculitis model in rabbits[J].,2018,(07):173.[doi:10.13798/j.issn.1009-153X.2018.03.011]
[5]李兴泽　李国良　潘文勇　李茂雷.高渗盐水与甘露醇联合治疗重型颅脑损伤后 颅内压增高的疗效[J].中国临床神经外科杂志,2019,(01):50.[doi:10.13798/j.issn.1009-153X.2019.01.016]

备注/Memo

备注/Memo:
（2018-10-13收稿，2018-11-30修回）通讯作者：史保中，E-mail：sbzmd20569@163.com
更新日期/Last Update: 2019-07-25