立体定向穿刺引流术治疗脑深部脓肿临床分析

Stereotactic puncture,aspiration and drainage for patients with deep-seated brain abscess

目的探讨立体定向穿刺引流术治疗脑深部脓肿的效果。方法回顾性分析2012年1月至2019年12月立体定向穿刺引流术治疗的7例脑深部脓肿的临床资料。结果6例为单发脓肿,1例为多房性脓肿;脓肿位于中脑1例,丘脑1例,基底节区1例,颞叶深部2例,额顶叶深部2例。术后5例脓肿消失,意识恢复清醒;1例虽意识恢复清醒,但最终因延髓炎症造成呼吸、心跳骤停死亡;1例颞部深部脓肿为多房性脓肿,单次穿刺引流不全后进一步开颅手术,最终治愈。结论立体定向穿刺引流术定位准确、安全、创伤小,是一种治疗脑深部脓肿有效方法,尤其单个脑深部脓肿。

Objective To explore the effect of stereotactic puncture,aspiration and drainage on the patients with deep-seated brain abscess.Methods The clinical data of 7 patients with deep-seated brain abscess who underwent stereotactic puncture,aspiration and drainage from January 2012 to December 2019 were analyzed retrospectively.Results Of these 7 patients,6 patients were single abscess,and 1 was multilocular abscess.One abscess was located in the midbrain,1 in the thalamus,1 in the basal ganglia,2 in the deep temporal lobe,and 2 in the deep frontal parietal lobe.After the drainage,5 patients whose abscesses were disappeared were cured,1 patient died of respiratory arreat or cardiac arrest due to inflammation of the medulla oblongata,and 1 patient with multilocular abscess in the deep temporal lope received craniotomy due to incomplete drainage and was finally cured.Conclusions The stereotactic puncture,aspiration and drainage,which has advantages such as accurate,safety,and minimally invasive,is a good method for the treatment of the patients with deep-seated brain abscess,especially for those with single deep-seated brain abscess.