中文摘要：

目的探讨美罗培南在预防颅内感染中的临床应用价值，为颅内感染的防治提供参考。方法选取在医院神经外科行开颅手术治疗的38例患者为研究对象，在术前30min给予1．0g美罗培南，分别收集患者静脉泵入美罗培南后30min、1、2、3、4h的血清和脑脊液标本，并检测各个时间点患者血清和脑脊液中的美罗培南药物浓度，计算出其脑脊液穿透率；与常见颅内感染致病菌的90％最低抑菌浓度对比，以探讨美罗培南预防颅内感染的临床效用。结果血清美罗培南药物浓度的峰值出现在静脉泵人美罗培南溶液后30min，为（53．14±3．85）mg／L；而脑脊液美罗培南药物浓度的峰值出现在静脉泵入美罗培南溶液后2h，为（2．91±0．16）mg／L，美罗培南的脑脊液穿透率为（13．68±7．19）％；美罗培南血清稳定药物浓度高于常见颅内感染致病菌的90％最低抑菌浓度，而仅有鲍氏不动杆菌和铜绿假单胞菌的90％最低抑菌浓度高于美罗培南的脑脊液稳定药物浓度。结论美罗培南对预防颅内感染具有良好的临床效用，值得在临床上进一步推广应用。

英文摘要：

OBJECTIVE To explore the clinical value of meropenem in prevention of intracranial infections so as to provide guidance for prevention and treatment of the intracranial infections. METHODS Totally 38 patients who un- derwent the craniotomy in department of neurosurgery were enrolled in the study, then all the subjects received in- travenous infusion of 1.0g meropenem at 30 min before the surgery, the serum and cerebrospinal fluid specimens were collected respectively at 30 min, 1 hour, 2 hours, 3 hours, and 4 hours after the intravenous infusion of mer- openem, the concentration of meropenem in the serum or cerebrospinal fluid was determined at each time point, the penetrating rate of the eerebrospinal fluid was calculated; by the comparison of the 90% MICs of the common species of pathogens causing intracranial infections, the clinical efficacy of meropenem in prevention of intracranial infections was evaluated. RESULTS The concentration of meropenem in the serum peaked as （53.14 ± 3.85）mg/L at 30 rain after the intravenous infusion of meropenem, while the concentration of meropenem in the cerebrospinal fluid peaked as （2.91 ±0.16）mg/L at 2 hours after the intravenous infusion of meropenem, and the rate of the meropenem＇ s penetrating the cerebrospinal fluid was （13.68± 7.19）%. The concentration of meropenem＇ s stabi- lizing drug concentrations in serum was higher than 90% MICs of the common species of pathogens causing in- tracranial infections, while only the 90% MICs of Acinetibacter baumannii and Pseudomonas aeruginosa were higher than those of meropenem＇ s stabilizing drug concentrations in the cerebrospinal fluid. CONCLUSION Mero- penem can achieve good clinical effect on prevention of the intracranial infections, and it is worthy to be promoted in the hospital.