| Objective:To investigate the clinical significance and diagnostic value of cerebrospinal fluid lactate level determination in the diagnosis of bacterial meningitis after craniotomy in patients with subarachnoid hemorrhage.Methdos:Using a retrospective approach,All patients who underwent neurosurgery from the General Hospital of the Northern Theater and who underwent surgery from October 2016 to December 2018 were selected,and 114 patients with subarachnoid hemorrhage who met the inclusion criteria were selected.Postoperative bedside lumbar puncture or lumbar spinal drainage,and take appropriate amount of cerebrospinal fluid specimens,sent to the unit’s laboratory for routine cerebrospinal fluid examination,biochemical examination and cerebrospinal fluid lactate level determination,and at the same time in the laboratory of cerebrospinal fluid bacterial culture.At the same time,the peripheral blood glucose was measured.According to the patient’s surgical method,cerebrospinal fluid examination results and clinical symptoms,combined with the latest diagnostic criteria for intracranial bacterial infection and diagnostic criteria for intracranial aseptic meningitis,patients were included in the subarachnoid hemorrhage interventional surgery group,subarachnoid space Patients with hemorrhagic craniotomy who were not complicated with meningitis,patients with aseptic meningitis after craniotomy and subarachnoid hemorrhage,and patients with bacterial meningitis after subarachnoid hemorrhage.Of the 113 patients included in the analysis,including 35 patients undergoing interventional surgery and 78 patients undergoing craniotomy;none of them had meningitis after interventional surgery,and 33 patients withoutcerebrospinal meningitis after craniotomy,31 patients developed aseptic meningitis and14 patients developed bacterial meningitis.By comparing the ratio of red blood cells to white blood cells in cerebrospinal fluid,cerebrospinal fluid protein content,blood sugar to cerebrospinal fluid sugar ratio,cerebrospinal fluid chlorine content,and cerebrospinal fluid lactate levels in different groups.To determine the clinical value of cerebrospinal fluid examination indicators for the diagnosis of meningitis after craniotomy in patients with subarachnoid hemorrhage and for the diagnosis of aseptic meningitis and bacterial meningitis after craniotomy in patients with subarachnoid hemorrhage Clinical Value.And by plotting the test parameters of the cerebrospinal fluid test for the diagnosis of meningitis caused by subarachnoid hemorrhage after craniotomy(ROC curve),determine the cerebrospinal fluid test indicators for subarachnoid hemorrhage craniotomy The diagnostic value of postoperative patients with bacterial meningitis.Result:1.For the differential diagnosis of subarachnoid hemorrhage in patients with aseptic meningitis and bacterial meningitis after craniotomy,only the cerebrospinal fluid lactate level.Cerebrospinal fluid erythrocyte leukocyte ratio,cerebrospinal fluid chlorine content,cerebrospinal fluid protein content,blood glucose cerebrospinal fluid sugar ratio is not meaningful for the differential diagnosis of aseptic meningitis and bacterial meningitis after craniotomy in patients with subarachnoid hemorrhage.2.ROC curve results showed that cerebrospinal fluid lactate level,blood glucose cerebrospinal fluid sugar ratio,cerebrospinal fluid chlorine content,cerebrospinal fluid erythrocyte leukocyte ratio and cerebrospinal fluid protein content were significant for the diagnosis of bacterial meningitis after subarachnoid hemorrhage.The area under the ROC curve is 0.966、0.847、0.832、0.810、0.730. |
