脑外伤行脑室引流后严重脑室炎的原因及处理

Reason and treatment of severe ventriculitis after lateral ventricle extradrainage in patients with brain injury

目的探讨脑外伤后行脑室外引流术后严重脑室炎的原因及处理。方法对8例脑外伤后行脑室外引流术后严重脑室炎患者,行双侧侧脑室穿刺,一侧用敏感抗生素慢速滴注冲洗,另一侧置管引流治疗,并且给予亚低温和高氧液及全身支持对症等治疗。结果治疗14d后各患者体温和脑脊液均恢复正常,伤后半年随访,根据GOS预后评分,持续植物状态1例,中残3例,恢复良好4例。结论脑外伤后行脑室外引流术后严重脑室炎患者采用敏感抗生素冲洗侧脑室、亚低温、高氧液及全身支持对症等治疗,可降低伤残率和死亡率。

To explore the reason and treatment of severe ventriculitis after the lateral ventricle extradrainage in the patients with brain injury. 8 patients with severe ventriculitis after the lateral ventricle extradrainage in the patients with brain injury were treated by puncturing bilateral lateral ventricle and douching one lateral ventricle by chosing the sensitive antibiotics and extradrainaging in another lateral ventricle, at the same time they accepted the treatment of mild hypothermia and high-oxygen liquid and supportive expectant treatment and so on. Body temperature and cerebral spinal fluid of all patients was normal by treating of 14 days. Six months after brain injury, all the cases were evaluated with GOS: 1 cases was vegetable, 3 moderate disabled, 4 good recovery. [Conclusion] Patients with severe ventriculitis after the lateral ventricle extradrainage in the patients with brain injury are douching lateral ventricle by chosing the sensitive antibiotics and accept the treatment of mild hypothermia and high-oxygen liquid and supportive expectant treatment in order to decrease deformity rate and mortality rate.