微血管减压术后6例颅内感染的早期诊治

Early diagnosis and treatment of 6 cases with intracranial infections after microvascular decompression

目的探讨微血管减压术后颅内感染的早期诊治方法。方法回顾性分析我科收治的131例行微血管减压术患者中术后发生颅内感染的6例患者临床资料,探讨其发生病因及早期诊治措施。结果微血管减压术后6例颅内感染患者,早期均行腰穿确诊,脑脊液白细胞计数均>0.01×109/L,多核白细胞>50%,其中2例脑脊液细菌培养结果为金黄色葡萄球菌(Staphylococcus aureus,SA),1例为表皮葡萄球菌(Staphylococcus epidermidis,SE),均对万古霉素(Vancomycin,VAN)敏感。6例患者均早期行腰大池持续引流,静脉联合鞘内注射敏感抗生素,两周内全部治愈。结论早期行腰穿及腰大池持续引流,静脉联合鞘内注射敏感抗生素,可以及时确诊并有效治愈微血管减压术后颅内感染。

Objective To investigate the early diagnosis and treatment of intracranial infections after micro- vascular decompression. Methods This retrospective study included 6 cases with intracranial infections after micro- vascular decompression of 131 cases, to study the causes, the early diagnosis and treatment of intracranial infections. Results Early lumbar puncture was purchased to confirm the diagnosis of intracranial infections in 6 cases,we found that the WBC in cerebrospinal fluid （CSF） for all patients with intracranial infections accounted more than 0.01 × 10 9/L, Polymorphonuclear leukocytes accounted more than 50%, CSF bacterial culture showed that the causative organisms were Staphylococcus aureus （SA） in 2 cases and Staphylococcus epidermidis （SE） in I case. Vancomycin （VAN） were all sensitive to the whole pathogenic bacteria. Within 2 weeks, the 6 cases who given all cured with early external lumbar drainage combined with sensitive antibiotics by the intrathecal injection. Conclusion It can help to improve early pe- riod diagnosis and treating effects on intracranial infections after microvascular decompression with early lumbar puncture and external lumbar drainage combined with sensitive antibiotics by the intrathecal injection.