内镜经鼻手术治疗鼻源性脑脓肿临床分析并文献回顾

Clinical analysis of transnasal endoscopic surgical treatment of nasogenic brain abscess with literature review

目的探讨鼻源性脑脓肿的发病原因、临床表现、诊断、治疗及预后,并分析鼻源性脑脓肿内镜手术的可行性,旨在提高耳鼻咽喉医生对该病的认识和治疗水平。方法报道3例鼻源性脑脓肿,并复习相关国内外文献。结果本组3例患者均行鼻源性脑脓肿内镜手术,2例经手术治疗后痊愈,1例转神经外科行立体定向下脑脓肿穿刺置管术+脑室穿刺外引流术治疗后痊愈。结论鼻源性脑脓肿少见,且症状多不典型。临床除传统治疗方式外,根据患者病情,鼻内镜手术可作为一种新的治疗手段。

Objective To summarize the pathogenesis,clinical features,diagnosis,treatment and prognosis of nasogenic brain abscess for exploring the feasibility of endoscopic surgery of this disease and improving the understanding and treatment level.Methods Clinical data of 3 patients suffering from nasogenic brain abscess were studied retrospectively with literature review.Results All the 3 patients received endoscopic surgical treatment.Of them,2 got cured with endoscopic surgery,one was transferred to the Department of Neurosurgery and got cured with stereotactic catheter drainage of abscess plus puncture and external drainage of ventricle.Conclusions Nasogenic brain abscess is rare and the symptoms are not typical.Treatment methods should be correctly selected according to the severity of the disease.In addition to the traditional method,transnasal endoscopic surgery may be used as a new treatment method according to the patient's condition.