经分流管储液囊脑室给药对脑室-腹腔分流术后颅内感染的治疗

Injection of antibiotics through reservoir to ventricle in the treatment of intracranial infection after ventriculoperitoneal shunt

目的探讨经分流管储液囊脑室内给药联合静脉给药对脑室-腹腔分流术后颅内感染的治疗效果。方法选取我科自2012年1月至2017年10月发生的10例脑室-腹腔分流术后颅内感染病例,均采用经脑室-腹腔分流管储液囊脑室内给药联合全身静脉给药治疗,回顾分析该组患者临床资料及治疗效果。结果该组10例患者中,脑脊液培养出耐甲氧西林表皮葡萄球菌2例,耐甲氧西林金黄色葡萄球菌1例,肠杆菌1例,脑脊液培养阴性6例,所有颅内感染患者均治愈,且均保留了脑室-腹腔分流管。结论经分流管储液囊行脑室内给药,联合全身静脉应用敏感抗生素对脑室-腹腔分流术后合并的颅内感染治疗有效,可降低拔除分流管风险。

Objective The therapeutic effect of intraventricular injection combined with intravenous administration on intracranial infection after ventriculoperitoneal shunt were studied. Methods A total of 10 cases of intracranial infection after ventriculoperitoneal shunt in our hospital from January 2012 to October 2017 were selected.All patients were treated by injection of antibiotics through reservoir to ventricle and systemic intravenous administration. The clinical data and therapeutic effects of the group were analyzed retrospectively. Results Among10 patients,2 cases were methicillin-resistant Staphylococcus epidermidis,1 case was methicillin-resistant Staphylococcus aureus,1 case was enterobacteriaceae,and 6 cases were negative for CSF culture. All intracranial infections were cured,and all ventriculoperitoneal shunt tubes were retained. Conclusion Injection of antibiotics through reservoir to ventricle combined with systemic intravenous antibiotics is effective for intracranial infection after ventriculoperitoneal shunt,and it can reduce the risk of removing shunt tube.