脑室-腹腔分流术后脑室内感染的原因及治疗

Etiology and treatment strategy of ventricle inflammation after ventriculoperitoneal shunt

目的探讨脑室-腹腔分流术后脑室内感染的致病原因及有效的治疗方案。方法回顾性分析89例因脑积水而行脑室-腹腔分流术治疗的患者的临床资料。结果 89例患者中有10例发生脑室内感染,发生率为11.24%,其中6例摘除分流管;对所有感染患者的血、脑脊液及摘除的分流管进行细菌培养,但阳性结果并不完全一致;所有患者都给予鞘内注入抗生素治疗,全部治愈出院。结论脑室-腹腔分流术后发生脑室内感染的可能致病因素很多,要从多方面预防才能降低感染率。患者若发生脑室内感染,可根据具体情况决定是否摘除分流管,鞘内注入抗生素治疗效果肯定。

Objective To study the etiology of ventricle inflammation after ventriculoperitoneal shunt and find out the effective therapeutic strategy.Methods The clinical data of 89 cases,who were suffered from hydrocephalus and treated with ventriculoperitoneal,were analyzed retrospectively.Results 10 of the 89 cases were diagnosed as ventricle inflammation,accounting for 11.24%.6 of the 10 cases with ventricle inflammation were removed of the shunts.The blood and cerebrospinal fluid （CSF） samples of the 10 cases and the removed shunts of the 6 cases were sent to the department of clinical laboratory for bacterial culture and tests of bacterial sensitivities to antibiotics,but the results were not coincidence.The infection of the cases,treating with lumber punctures to release the CSF and intrathecally administrate the efficacious diluted antibiotics,were satisfactorily controlled.Conclusion Many etiologies are responded to the ventricle inflammation after ventriculoperitoneal shunt,so it should be prevented from many aspects to decrease the infection rat.Whether removed the shunts is according to the condition of the patient.Intrathecally administrate the efficacious diluted antibiotics is an effective way to treat with the ventricle inflammation after ventriculoperitoneal shunt.