比较腰椎穿刺鞘内注射地塞米松与静脉推注地塞米松治疗显微血管减压术（MVD）术后无菌性脑膜炎（AM）的临床疗效。

选择自2015年1月至2020年1月于胜利油田中心医院神经外科就诊行MVD并诊断为AM的138例患者为研究对象，将患者分为对照组（68例）和观察组（70例）。对照组患者采用静脉推注地塞米松（10 mg/次）治疗，频率为按需给药；观察组患者采用腰穿放液联合鞘内注射地塞米松[60 μg/（kg·次）]治疗，频率为每日或隔日1次。比较2组患者治疗后的头痛及发热缓解情况、术后住院时间、治疗次数及激素不良反应情况。

治疗后8、72 h后，2组患者头痛、发热症状均明显好转，且观察组明显优于对照组，差异均有统计学意义（P<0.05）；观察组患者的术后住院时间[（7.68±2.23）d]短于对照组[（12.76±2.37）d]，治疗次数[（3.5±0.6）次]明显低于对照组[（6.8±0.9）次]，差异具有统计学意义（P<0.05），2组患者均未见明显的激素不良反应。

腰穿放液联合鞘内注射地塞米松在治疗MVD术后AM患者中疗效确切，可有效改善患者头痛、发热等临床症状，减轻激素用量，缩短术后住院时间，具有重要的临床推广价值。

To comparison of the clinical effect of dexamethasone intrathecal injection and intravenous injection for aseptic meningitis (AM) after microvascular decompression (MVD).

One hundred and thirty-eight patients with AM after MVD in Department of Neurosurgery of Shengli Oilfield Central Hospital from January 2015 to January 2020 were selected as the research objects, and they were divided into control group and observation group. Sixty-eight patients in the control group were treated with intravenous injection of dexamethasone (10 mg/time), the frequency was on-demand administration; 70 patients in the observation group were treated with lumbar puncture liquid and intrathecal injection of dexamethasone (60 μg/(kg·times), the frequency was once a day or the next day. The remission of headache and fever, postoperative hospital stay, frequency of treatment, and adverse effects of steroid were compared between the two groups.

At 8 and 72 h after treatment, the headache and fever of the two groups were remission, and the observation group was significantly better than the control group (P<0.05). The postoperative hospital stay of the observation group [(7.68±2.23) d] was significantly shorter than that of the control group [(12.76±2.37) d, P<0.05]. The frequency of treatment of the observation group (3.5±0.6) was significantly lower than that of the control group (6.8±0.9) (P<0.05). No significant adverse effects were observed in both groups.

The combination of lumbar puncture and dexamethasone intrathecal injection is significantly effective in treating AM after MVD, which can effectively improve the headache, fever and other clinical symptoms, reduce the amount of hormone, and shorten the postoperative hospital stay, and is worthy of promotion.