临床神经外科杂志2018，Vol.15Issue(3)：193-199,7.DOI:10.3969/j.issn.1672-7770.2018.03.009
严重颅内感染的综合诊疗策略
Combined therapeutic strategies for severe intracranial infection
摘要
Abstract
Objective To study the effective comprehensive therapeutic strategies for severe CNS infection , especially ventriculitis .Methods The clinical data of 211 CNS infection patients including 28 ventriculitis patients were analyzed retrospectively .Four cases of serious intracranial infection were treated by bilateral anterion horn of lateral ventricle catheterization , 24 hours continuous flushing with natural saline containing antibiotics and drainage .If flushing fluid was clear,lumbar cistern drainage was used .If abscess was in non-functional area,it should be resected before lateral external ventricular drainage .When adhesion and partition in ventricle was formed , ventricularendoscopy surgery was needed .The ventriculo-peritoneal shunt or endoscopic third ventriculostomy was needed if hydrocephalus happened .Results Positive rate of CSF cultivation in 211 CNS infection patients was 13.3%.Curative rate of CNS infection patients with negative CSF cultivation was 92.9% while that of CNS infection patients with positive CSF cultivation was 42.8%.Among 28 ventriculitis patients, positive rate of CSF cultivation was 42.8% with total curative rate of 67.8%.Curative rate of ventriculitis patients with negative CSF cultivation was 75%while that of ventriculitis patients with positive CSF cultivation was 58 .3%.These 4 patients were all cured.The time of external ventricle drainage (EVD) were 7-47 days.Follow-up periods ranged from 3 to 9 months showed all patients had no infection recurrence .Conclusion Bilateral EVD continuous flushing and drainage , combined with ventricularendoscope operation are effective treatments for severe intracranial infection ,especially ventriculitis and pyocephalus .关键词
重度颅内感染/双侧脑室穿刺/冲洗Key words
severe intracranial infection/punctio ventricularis/flushing and drainage分类
医药卫生引用本文复制引用
王强,王汉东,潘灏,孙康健,武燕,丁惠..严重颅内感染的综合诊疗策略[J].临床神经外科杂志,2018,15(3):193-199,7.基金项目
南京大学医学院附属金陵医院院管课题(2017006) （2017006）
