目的 評價萬古霉素靜脈滴注聯(lián)用鞘內(nèi)注射治療顱內(nèi)感染的有效性和安全性。方法 檢索2000年1月-2017年5月PubMed、中國知網(wǎng)（CNKI）、萬方數(shù)據(jù)庫、維普全文數(shù)據(jù)庫（VIP）中的數(shù)據(jù)，收集萬古霉素靜脈滴注聯(lián)用鞘內(nèi)注射治療顱內(nèi)感染的臨床隨機對照研究（RCT），采用RevMan 5.2軟件進行Meta分析。結果 共納入9項RCTs，469例患者。Meta分析結果顯示：相對于萬古霉素靜脈滴注，聯(lián)用鞘內(nèi)注射能顯著提高臨床治愈率[RR=0.70，95%CI（0.61，0.81），P < 0.001]和耐甲氧西林金黃色葡萄球菌清除率[RR=0.90，95%CI（0.81，1.00），P=0.04]，縮短治愈時間[SMD=3.26，95%CI（2.84，3.68），P < 0.001]；兩組不良反應發(fā)生率無統(tǒng)計學差異[RR=0.73，95%CI（0.35，1.49），P=0.38]，但中樞神經(jīng)根刺激癥發(fā)生率較大[RR=0.05，95%CI（0.00，0.92），P=0.04]。結論 萬古霉素靜脈滴注聯(lián)用鞘內(nèi)注射治療顱內(nèi)感染療效確切，安全性好。

Objective To evaluate the efficacy and safety of vancomycin intravenous infusion combined with intrathecal injection in treatment of intracranial infection. Methods Databases including PubMed, CNKI, VIP, and WanFang Data were searched to collect randomized controlled trials (RCTs) about vancomycin intravenous infusion combined with intrathecal injection in treatment of intracranial infection from January 2000 to May 2017. Meta-analysis was conducted by RevMan 5.2 software. Results Nine RCTs were collected, including 469 patients. The meta-analysis showed that, compared with intravenous infusion of vancomycin, intravenous infusion combined with intrathecal injection could significantly improve the clinical cure rate[RR=0.70, 95%CI(0.61, 0.81), P < 0.001] and clearance rate of MRSA[RR=0.90, 95%CI(0.81, 1.00), P=0.04], shorten the cure time[SMD=3.26, 95%CI(2.84, 3.68), P < 0.001]. Also, there was no statistical difference in the incidence of adverse drug reactions[RR=0.73, 95%CI(0.35, 1.49), P=0.38], but the incidence of central nerve root irritation was higher[RR=0.05, 95%CI(0.00, 0.92), P=0.04]. Conclusion Vancomycin intravenous injection combined with intrathecal injection is effective and safe in the treatment of intracranial infection.