目的:比较腹腔镜辅助下脑室-腹腔分流术与传统脑室-腹腔分流术治疗脑积水的临床效果。方法:对78例脑积水患者的临床资料进行回顾性分析,其中39例(观察组)采用腹腔镜辅助下脑室-腹腔分流术治疗,39例(对照组)采用传统脑室-腹腔分流术治疗...目的:比较腹腔镜辅助下脑室-腹腔分流术与传统脑室-腹腔分流术治疗脑积水的临床效果。方法:对78例脑积水患者的临床资料进行回顾性分析,其中39例(观察组)采用腹腔镜辅助下脑室-腹腔分流术治疗,39例(对照组)采用传统脑室-腹腔分流术治疗。比较两组腹部手术时间、术后住院时间、术后1周临床疗效、并发症以及术后6个月Karnofsky功能状态评分、Barthel指数和美国国立卫生研究院卒中量表(the National Institutes of Health Stroke Scale,NIHSS)评分。结果:观察组腹部手术时间(15.33±1.71)min,术后住院时间(8.67±1.67)d,短于对照组的(27.77±3.06)min和(11.74±3.26)d(均P<0.001)。术后1周观察组总有效率71.89%,高于对照组的53.85%(P=0.038)。观察组术后并发症总发生率5.13%,低于对照组的25.64%(P=0.025)。术后6个月观察组Karnofsky评分为(76.51±13.88)分,Barthel指数为(82.82±7.09)分,分别高于对照组的(69.92±15.78)分和(77.18±5.06)分,观察组NIHSS评分为(10.38±1.44)分,低于对照组的(14.85±1.91)分(均P<0.05)。结论:与传统脑室-腹腔分流术比较,腹腔镜辅助下脑室-腹腔分流术手术时间短,创伤小,术野直观清晰,能更有效降低术后并发症的发生,改善患者神经功能和日常活动能力,具有较高的临床应用价值。展开更多
BACKGROUND Brain abscess is a serious and potentially fatal disease caused primarily by microbial infection.Although progress has been made in the diagnosis and treatment of brain abscesses,the diagnostic timeliness o...BACKGROUND Brain abscess is a serious and potentially fatal disease caused primarily by microbial infection.Although progress has been made in the diagnosis and treatment of brain abscesses,the diagnostic timeliness of pathogens needs to be improved.CASE SUMMARY We report the case of a 54-year-old male with a brain abscess caused by oral bacteria.The patient recovered well after receiving a combination of metagenomic next-generation sequencing(mNGS)-assisted guided medication and surgery.CONCLUSION Therefore,mNGS may be widely applied to identify the pathogenic microor-ganisms of brain abscesses and guide precision medicine.展开更多
BACKGROUND This case series investigated the clinical manifestations,diagnoses,and treatment of cerebral abscesses caused by Streptococcus anginosus.We retrospectively analyzed the clinical characteristics and outcome...BACKGROUND This case series investigated the clinical manifestations,diagnoses,and treatment of cerebral abscesses caused by Streptococcus anginosus.We retrospectively analyzed the clinical characteristics and outcomes of three cases of cerebral abscesses caused by Streptococcus anginosus and conducted a comprehensive review of relevant literature.CASE SUMMARY Case 1 presented with a history of left otitis media and exhibited high fever,confusion,and vomiting as primary symptoms.Postoperative pus culture indicated a brain abscess caused by Streptococcus constellatus infection.Case 2 experienced dizziness for two days as the primary symptom.Postoperative pus culture suggested an intermediate streptococcal brain abscess.Case 3:Enhanced head magnetic resonance imaging(MRI)and diffusion-weighted imaging revealed occupancy of the left temporal lobe,initially suspected to be a metastatic tumor.However,a postoperative pus culture confirmed the presence of a brain abscess caused by Streptococcus anginosus infection.The three cases presented in this case series were all patients with community-acquired brain abscesses resulting from angina caused by Streptococcus group infection.All three patients demonstrated sensitivity to penicillin,ceftriaxone,vancomycin,linezolid,chloramphenicol,and levofloxacin.Successful treatment was achieved through stereotaxic puncture,drainage,and ceftriaxone administration with a six-week course of antibiotics.CONCLUSION Preoperative enhanced head MRI plays a critical role in distinguishing brain tumors from abscesses.Selecting the correct early diagnostic methods for brain abscesses and providing timely intervention are very important.This case series was in accordance with the CARE guidelines.展开更多
特发性正常压力脑积水(idiopathic normal pressure hydrocephalus,iNPH)由于诊断阳性率低以及缺乏安全有效的检测指标,导致能接受正确治疗的iNPH患者仅占实际iNPH患者一小部分。目前相关研究证明脑脊液生物标记物有助于iNPH诊断。本文...特发性正常压力脑积水(idiopathic normal pressure hydrocephalus,iNPH)由于诊断阳性率低以及缺乏安全有效的检测指标,导致能接受正确治疗的iNPH患者仅占实际iNPH患者一小部分。目前相关研究证明脑脊液生物标记物有助于iNPH诊断。本文结合国内外文献,就脑脊液生物标记物在iNPH的研究进展进行综述,以期为后续研究及临床诊疗提供一定参考。展开更多
文摘目的:比较腹腔镜辅助下脑室-腹腔分流术与传统脑室-腹腔分流术治疗脑积水的临床效果。方法:对78例脑积水患者的临床资料进行回顾性分析,其中39例(观察组)采用腹腔镜辅助下脑室-腹腔分流术治疗,39例(对照组)采用传统脑室-腹腔分流术治疗。比较两组腹部手术时间、术后住院时间、术后1周临床疗效、并发症以及术后6个月Karnofsky功能状态评分、Barthel指数和美国国立卫生研究院卒中量表(the National Institutes of Health Stroke Scale,NIHSS)评分。结果:观察组腹部手术时间(15.33±1.71)min,术后住院时间(8.67±1.67)d,短于对照组的(27.77±3.06)min和(11.74±3.26)d(均P<0.001)。术后1周观察组总有效率71.89%,高于对照组的53.85%(P=0.038)。观察组术后并发症总发生率5.13%,低于对照组的25.64%(P=0.025)。术后6个月观察组Karnofsky评分为(76.51±13.88)分,Barthel指数为(82.82±7.09)分,分别高于对照组的(69.92±15.78)分和(77.18±5.06)分,观察组NIHSS评分为(10.38±1.44)分,低于对照组的(14.85±1.91)分(均P<0.05)。结论:与传统脑室-腹腔分流术比较,腹腔镜辅助下脑室-腹腔分流术手术时间短,创伤小,术野直观清晰,能更有效降低术后并发症的发生,改善患者神经功能和日常活动能力,具有较高的临床应用价值。
文摘BACKGROUND Brain abscess is a serious and potentially fatal disease caused primarily by microbial infection.Although progress has been made in the diagnosis and treatment of brain abscesses,the diagnostic timeliness of pathogens needs to be improved.CASE SUMMARY We report the case of a 54-year-old male with a brain abscess caused by oral bacteria.The patient recovered well after receiving a combination of metagenomic next-generation sequencing(mNGS)-assisted guided medication and surgery.CONCLUSION Therefore,mNGS may be widely applied to identify the pathogenic microor-ganisms of brain abscesses and guide precision medicine.
基金Supported by 2024 Zhejiang Province Traditional Chinese Medicine Science and Technology Plan,No.2024ZL1129,No.2024ZL1130.
文摘BACKGROUND This case series investigated the clinical manifestations,diagnoses,and treatment of cerebral abscesses caused by Streptococcus anginosus.We retrospectively analyzed the clinical characteristics and outcomes of three cases of cerebral abscesses caused by Streptococcus anginosus and conducted a comprehensive review of relevant literature.CASE SUMMARY Case 1 presented with a history of left otitis media and exhibited high fever,confusion,and vomiting as primary symptoms.Postoperative pus culture indicated a brain abscess caused by Streptococcus constellatus infection.Case 2 experienced dizziness for two days as the primary symptom.Postoperative pus culture suggested an intermediate streptococcal brain abscess.Case 3:Enhanced head magnetic resonance imaging(MRI)and diffusion-weighted imaging revealed occupancy of the left temporal lobe,initially suspected to be a metastatic tumor.However,a postoperative pus culture confirmed the presence of a brain abscess caused by Streptococcus anginosus infection.The three cases presented in this case series were all patients with community-acquired brain abscesses resulting from angina caused by Streptococcus group infection.All three patients demonstrated sensitivity to penicillin,ceftriaxone,vancomycin,linezolid,chloramphenicol,and levofloxacin.Successful treatment was achieved through stereotaxic puncture,drainage,and ceftriaxone administration with a six-week course of antibiotics.CONCLUSION Preoperative enhanced head MRI plays a critical role in distinguishing brain tumors from abscesses.Selecting the correct early diagnostic methods for brain abscesses and providing timely intervention are very important.This case series was in accordance with the CARE guidelines.
文摘特发性正常压力脑积水(idiopathic normal pressure hydrocephalus,iNPH)由于诊断阳性率低以及缺乏安全有效的检测指标,导致能接受正确治疗的iNPH患者仅占实际iNPH患者一小部分。目前相关研究证明脑脊液生物标记物有助于iNPH诊断。本文结合国内外文献,就脑脊液生物标记物在iNPH的研究进展进行综述,以期为后续研究及临床诊疗提供一定参考。
