88例脑脓肿的临床诊治回顾分析

Diagnosis and treatment of brain abscess( a report of 88 cases)

目的探讨脑脓肿的临床诊治特点及预后情况,为临床治疗方案的制定提供依据。方法回顾分析我科收治的88例脑脓肿患者的临床特点、治疗方案及预后情况,保守治疗16例,立体定向穿刺引流23例,开颅脓肿切除49例。结果本组病例中隐源性脓肿43例,其次是血源性23例,耳源性14例,医源性5例,外伤性3例。44例行细菌培养,阳性16例。治愈82例,植物生存1例,死亡5例。结论脑脓肿若能及时正确的诊治,能够取得较好的结果,患者的基础疾病,治疗前的颅内压增高情况和脓肿是否破入脑室是决定预后的重要因素。

Objective To investigate the characteristics and prognosis of the clinical diagnosis and treatment of brain abscess. Methods The clinical features, treatment options and prognosis of the 88 patients who were treated in our department were analyzed retrospectively. Of 94 patients, 16 were treated by simple medical methods, 23 were treated with puncture drainage and irrigation method and 49 were treated by craniotomy. Results The number of this group caused by cryptogenic abscesses up to 43 cases, followed by 23 hematogenous brain abscesses, 14 were otogenic brain abscesses ,5 subjects from iatrogenic and 3 trauma. Of 44 cases of bacterial culture, 16 were positive. As a result 82 cases were cured, 1 was in persistent vegetative state and 5 died. Conclusions Correct diagnosis and timely treatment of brain abscess could achieve better result. The underlying diseases,intracranial hypertension before treatment and abscesses of breaking into the ventricles are important factor to predict the prognosis.