目的:探讨脑脊液置换联合鞘内注药法对妊娠期妇女结核性脑膜炎的临床疗效。方法:选取孕期结核性脑膜炎患者68例随机分为两组,对照组34例采用常规抗结核治疗,观察组34例采用脑脊液置换联合鞘内注药治疗并实施保健知识宣教。比较两组患者的临床指征、临床疗效、并发症情况,分析两组患者对保健知识的掌握情况。结果:两组患者胎儿均健康,观察组患者头痛消失时间、发热消失时间、颅压恢复时间、蛋白恢复时间、细胞恢复时间、住院时间均明显少于对照组,观察组对保健知识的掌握情况明显好于对照组,差异均有统计学意义(P<0.05)。观察组治疗总有效率100.0%高于对照组97.1%,观察组并发症发生率2.9%低于对照组8.8%,但差异均无统计学意义(P>0.05)。结论:脑脊液置换联合鞘内注药治疗可明显改善妊娠期妇女结核性脑膜炎患者的临床指征,提高治愈率,引发的并发症少且安全性高;同时实施的保健知识宣教可以显著提高孕期妇女对自身健康的重视程度,有助于疾病治疗的顺利开展。 Objective: To investigate the clinical effect of cerebrospinal fluid replacement combined with intrathecal injection on tuberculous meningitis in pregnant women. Methods: Sixty-eight patients with tuberculous meningitis during pregnancy were randomly divided into two groups. The control group received routine anti-TB therapy. The observation group was treated with cerebrospinal fluid replacement and intrathecal injection and implemented health knowledge education. The clinical indications, clinical curative effects and complications of the two groups were compared, and the mastery of health knowledge was analyzed between the two groups. Results: The fetuses of both groups were healthy. The disappearance of headache, disappearance of fever, recovery time of intracranial pressure, protein recovery time, cell recovery time and hospitalization time in the observation group were significantly less than those in the control group and observation group Obviously better than the control group, the difference was statistically significant (P <0.05). The total effective rate of observation group was 100.0% higher than 97.1% of control group, 2.9% of observation group complication rate was lower than 8.8% of control group, but the difference was not statistically significant (P> 0.05). Conclusion: Cerebrospinal fluid replacement combined with intrathecal injection therapy can significantly improve the clinical indications of tuberculous meningitis in pregnant women, improve the cure rate, lead to fewer complications and high safety; at the same time, the implementation of health education can significantly improve the knowledge of pregnancy Women’s emphasis on their own health, contribute to the smooth development of disease treatment.