CT引导下微创穿刺联合持续冲洗引流治疗脑脓肿的疗效研究

Effect of CT-guided Minimally Invasive Puncture Combined with Continuous Irrigation and Drainage on Patients with Brain Abscess

目的分析CT引导下微创穿刺联合持续冲洗引流治疗脑脓肿的临床疗效。方法选择2010年1月至2014年1月在自贡市第三人民医院接受治疗的脑脓肿患者84例,按照随机数字表法分为两组:对照组(42例)接受小骨窗开颅脓肿清除治疗,观察组(42例)接受CT引导下微创穿刺联合持续冲洗引流治疗。比较两组患者的神经功能评分、康复评分、脓肿清除率及术后并发症等。结果治疗后2周和4周,两组患者的神经功能评分均高于治疗前,且观察组患者的神经功能评分高于对照组(P<0.05);观察组患者接受治疗后的肢体运动功能评分及Barthel指数评分均显著高于对照组(P<0.05);观察组患者接受治疗后的脓肿清除率显著高于对照组,术后并发症总发生率显著低于对照组(P<0.05或P<0.01)。结论 CT引导下微创穿刺联合持续冲洗引流治疗可以有效提高脓肿清除率、改善患者的神经功能、加速其术后康复,且具有较低的术后并发症发生率。

Objective To analyze the effect of CT-guided minimally invasive puncture combined with continuous irrigation and drainage on patients with brain abscess .Methods A total of 84 cases with brain abscess admitted to Zigong Third People′s Hospital from Jan.2010 to Jan.2014 were randomly assigned to observation group（42 cases） receiving CT-guided minimally invasive puncture combined with continuous irri-gation and drainage and control group（42 cases） receiving small bone window craniotomy abscess clearance, and the neurological score,rehabilitation score,hematoma clearance rate and postoperative complications rate of the two groups were compared.Results Two weeks and four weeks after treatment,neurological score of both groups were higher than those before treatment;the neurological score of the observation group was sig-nificantly higher than the control group（P〈0.05）.The limb motor function score and Barthel index score of the observation group were significantly higher than the control group（P〈0.05）.The abscess clearance rate of the observation group was significantly higher than the control group,and the postoperative complications incidence was significantly lower than the control group （ P〈0.05 or P〈0.01 ） .Conclusion CT-guided minimally invasive puncture joint continuous irrigation and drainage of abscess therapy can effectively improve the clearance rate,improve neurological function of the patients with accelerated postoperative reha-bilitation,and less postoperative complications.