脑室-腹腔分流术后颅内感染因素分析及治疗体会

Analysis of factors and treatment of intracranial infection after ventriculoperitoneal shunt

目的总结脑室-腹腔分流术(VPS)后感染的因素及治疗方法。方法回顾性分析了2019年01月至2022年01月河南大学附属郑州颐和医院神经外科收治的22例脑室-腹腔分流术后感染病例。结果根据感染发生的时间,将脑室-腹腔分流术后感染分为急性感染(3~7 d)、亚急性感染(8~14 d)、晚期感染(>14 d)。其中急性感染16例,亚急性感染4例,晚期感染2例。所有病例均进行了脑脊液培养,阴性8例,葡萄球菌12例,肠球菌1例,克雷白杆菌1例。22例患者均给予静脉抗生素、腰大池引流、鞘内注射抗生素等规范治疗,16例治愈(72.8%),5例拔除分流管(22.7%),1例死亡(4.5%)。结论脑室-腹腔分流术后感染早期发现,早期诊断,通过综合治疗,可以避免二次手术的风险和减少患者的经济负担。

Objective To explode the factors and treatments of intracranial infection after ventriculoperitoneal shunt(VPS).Methods The clinical data of 22 patients with intracranial infection after VPS,who were treated in our hospital from 2019 to 2022,were analyzed retrospectively.Results According to the time of infection after VPS,the intracranial infection was divided into acute infection(3-7d),subacute infection(8-14d)and late infection(>14d).There were 16 cases of acute infection,4 cases of subacute infection and 2 cases of late infection.Cerebrospinal fluid culture was performed in all cases,and 8 cases were negative,including 12 cases of staphylococcus,1 case of enterococcus and 1 case of klebsiella.All the 22 patients received standard treatment such as intravenous antibiotics,lumbar cistern drainage and intrathecal injection of antibiotics,among which 16 cases were cured(72.8%),5 cases were discharged(22.7%)and 1 case died(4.5%).Conclusion Early detection and early diagnosis of intracranial infection after VPS can avoid the risk of secondary surgery and reduce the economic burden of patients.