脑室-腹腔分流术后脑室炎的诊治

Diagnosis and treatment for ventriculitis associated with ventriculoperitoneal shunt

目的探讨脑室-腹腔（V-P）分流术后相关脑室炎的有效治疗方法。方法全组9例均从分流阀抽取脑脊液细菌培养。7例拔除原分流管同时行脑室外引流；2例利用原分流管行脑室外引流。7例病人脑室内应用万古霉素，全组病例均静脉应用敏感的抗生素。脑室炎治愈后再行V-P分流。结果7例为表皮葡萄球菌或和金黄色葡萄球菌感染。7例治愈，2例分流术后再度感染。结论拔除分流管、脑室外引流、敏感抗生素的使用及感染治愈后再次分流是治疗V-P分流相关脑室炎最有效的方法。

Objective To explore the effective method of treatment for ventriculitis associated with ventriculoperitoneal shunt. Method Bacterial culture of cerebrospinal fluid （CSF） from shunt reservoir were performed for all the patients. The shunts of 7 patients were removed and external ventricular drainage was done at meantime, for the other 2 patients, only the abdominal parts of the shunts were pulled out. 7 cases received vancomycin intraventricularly, and all the patients had sensitive antibiotic treatment intraveinously. Another CSF shunt was placed for all the patients when ventriculitis was cured. Result 7 eases were infected by Staphylococcus epidermidis and/or Staphylececeus aureus. 7 patients were cured, and the other 2 patients were infected again after another CSF shunt had been placed. Conclusion Shunt removal, external ventricular drainage, sensitive antibiotics and another CSF shunt placement when CSF sterilized are the most effective methods of treatment for ventriculitis associated with V-P shunt.