不典型症状的儿童脑脓肿临床分析

Clinical analysis of brain abscess in children with untypical manifestation

目的分析症状不典型的儿童脑脓肿的临床特点及其诊治策略。方法回顾性分析46例脑脓肿患儿的临床表现及相关检查资料。结果临床表现有发热31例,呕吐25例,头痛21例;脓肿好发于颞叶,以单发脓肿多见;细菌培养阳性率52.4%;手术治疗24例,保守和手术治疗有效率分别为86.4%和87.5%,总死亡率8.7%。结论儿童脑脓肿的症状隐匿,头颅CT扫描有助于早期确诊,治疗方案应结合病情有所选择。

Objective To analyze clinical feature of brain abscess in children with untypical manifestation and improve its diagnosis and therapeutic efficiency. Mtheods A retrospective investigation of clinical data, including manifestation, image examination, therapeutic methods and outcome, was conducted on 46 cases with brain abscess in children. Results The peak ages were eight to fourteen years （26 cases）. The most common presenting symptoms were fever（31 cases）, vomiting（25 cases）, and headache（21 cases）. The most common localization of brain abscess was temporal lobe. Single abscess was the most common type. The positive rate of microbiological test was 52.4 %. Among these patients, 24 were surgically operated. The efficiency rate of surgical operation and drug treatment were 86.4 % and 87.5 % respectively. Total mortality rate was 8.7 %. Conclusion The hiding symptoms are the reason that causes misdiagnosis of brain abscess in children. CT scanning facilitates early diagnosis. The proper management, optimal timing of surgery or appropriate use of antibiotics should be selected according to the patient＇s status.