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脊柱脊髓外科术后脑脊液漏合并感染的病原菌分析及临床治疗策略 被引量:7
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作者 杨辰龙 VanHalm-Lutterodt Nicholas +3 位作者 梁辰 刘铁 徐宇伦 刘晓光 《中国病原生物学杂志》 CSCD 北大核心 2020年第3期327-331,共5页
目的研究脊柱脊髓外科术后脑脊液漏合并感染的病原菌分布及其药物敏感性,并探讨临床治疗策略。方法选取脊柱脊髓外科术后脑脊液漏合并感染患者36例,收集脑脊液标本进行菌株分离、培养及鉴定,并做药敏试验;患者给予全身和局部抗生素治疗... 目的研究脊柱脊髓外科术后脑脊液漏合并感染的病原菌分布及其药物敏感性,并探讨临床治疗策略。方法选取脊柱脊髓外科术后脑脊液漏合并感染患者36例,收集脑脊液标本进行菌株分离、培养及鉴定,并做药敏试验;患者给予全身和局部抗生素治疗,并评价抗感染治疗效果。结果共分离出病原菌39株,其中革兰阳性菌14株(35.9%),以金黄色葡萄球菌、表皮葡萄球菌及溶血性链球菌多见;革兰阴性菌25株(64.1%),主要为肺炎克雷伯杆菌、大肠埃希菌、铜绿假单胞菌及鲍曼不动杆菌。革兰阳性菌对万古霉素的敏感性达100%,对第三代头孢菌素类抗生素敏感率<50%,对大环内酯类、氨基糖苷类、磺胺类抗生素敏感率<10%。革兰阴性菌对美罗培南的敏感性>90%,对第三代头孢菌素类抗生素敏感率<60%,对青霉素类抗生素敏感率<10%。全身治疗采用美罗培南与万古霉素的联合抗感染方案,局部治疗采用腰椎置管引流,鞘内注射万古霉素,所有病例均于4周内得到稳定控制。结论革兰阳性菌和革兰阴性菌在脊柱脊髓外科手术术后脑脊液漏合并感染中均较常见,万古霉素对革兰阳性菌敏感率较高,而革兰阴性菌对美罗培南具有良好的药物敏感性。因此建议该病的治疗采用早期联合静脉滴注美罗培南和万古霉素方案,同时行腰椎置管引流及鞘内注射万古霉素。 展开更多
关键词 脊柱脊髓外科 脑脊液漏 感染 病原菌 抗生素 药敏
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Long-term P300 in hemispherectomized patients 被引量:1
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作者 TONG Xian-zeng xu yu-lun FU Zhuang 《Chinese Medical Journal》 SCIE CAS CSCD 2009年第15期1769-1774,共6页
Background In the years around 1990, in Beijing 13antan Hospital Affiliated to Capital Medical University many children with infantile hemiplegia and intractable epilepsy were treated with further modified anatomical ... Background In the years around 1990, in Beijing 13antan Hospital Affiliated to Capital Medical University many children with infantile hemiplegia and intractable epilepsy were treated with further modified anatomical hemispherectomy. We report the follow up of the first six cases. To make good use of these precious clinical data and make clear their neuropsychological state, we performed neuropsychological and neurophysiological measurements in these patients, who were at a median of 17.8 years after hemispherectomy. Methods Oddball task was given to the patients and to a normal control group to collect the peak latency (PL) and peak amplitude (PA) of event-related potentials (ERPs)-P300. The P300 data of the two groups were analyzed and the P300 patterns of the six patients are presented. The baseline characteristics and long-term follow-up of the six hemispherectomized patients, especially the long-term seizure control and cognitive function after surgery, are described. Results Five patients had no seizures and one was almost seizure-free during the years after surgery. Clear P300 was obtained from every electrode in the patients. Differences of P300 between patients and normal control group had no statistical significance. And the maximum PA was at the site of electrode Pz or Cz which was consistent with that of the control group and with previous findings. Conclusions Further modified anatomical hemispherectomy has preferable long-term antiepileptic effects. The P300 results of the patients mean that the basic cognitive function of the patients has no difference from the control group. This reflects the plasticity of the hemisphere to some extent and increases the affirmation of the long-term curative effects of further modified anatomical hemispherectomy from both neuropsychological and neurophysiological aspects. 展开更多
关键词 LONG-TERM HEMISPHERECTOMY cognitive function P300
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