脑室-腹腔分流术后并发脑室炎的诊断及治疗

Diagnosis and Treatment of Ventriculitis as A Complication after Ventriculo-peritoneal (V-P) Shunt

目的 总结 6例脑室 腹腔 (v p)分流术后并发脑室炎的诊断及治疗。方法 对我院 1993～ 2 0 0 0年间行V P分流术 10 8例中并发脑室炎的 6例进行回顾性分析。结果 金黄色葡萄球菌 2例 ,表皮葡萄球菌 2例 ,铜绿假单胞菌 1例 ,肺炎链球菌及大肠埃希菌混合感染 1例 ,治愈 4例 ,死亡 2例。结论 尽早行脑脊液储液泵细菌培养加药敏 ,选择敏感抗生素抗感染 ,同时拔除分流管 ,引流炎性脑脊液 ,感染控制后再行V P分流术。

OBJECTIVE To summarize the diagnosis and treatment of ventriculitis as a complication after ventriculo-peritoneal (V-P) shunt. METHODS The clinical data of 6 cases of ventriculitis after V-P shunt were retrospectively analyzed. RESULTS Two cases were invaded by Staphylococcus aureus, 2 cases by S.epidermidis, 1 case by Bacillus pyocyaneus, and 1 case by combination of Streptococcus pneumoniae and Escherichia coli. After treatment 4 cases were healed, and 2 cases died. CONCLUSIONS As to this disease, bacterial culture of cerebrospinal fluid in the pump of the shunt tube and drug sensitivity test should be early applied to instruct the selection of antibiotics. Other measures include removing of the shunt tube and drainage of the inflammatory cerebrospinal fluid. V-P shunt should be reapplied after control of infection.