基底节区脑脓肿并发脑疝手术治疗的方法及预后  

The Operation and Prognosis of Brain Abscesses in Basal Ganglia with Cerebral Herniation

作　　者：潘仁龙[1] 夏鹰[2] 高幸[3] 

机构地区：[1]上海交通大学第六人民医院金山分院神经外科,201500 [2]复旦大学附属上海第五人民医院神经外科,200240 [3]复旦大学附属华山医院神经外科邮电分院,200040

出　　处：《中国临床神经科学》2008年第2期165-169,共5页Chinese Journal of Clinical Neurosciences

摘　　要：目的:探讨基底节区脑脓肿并发脑疝手术治疗的方法及预后。方法:回顾性分析2002年1月至2007年6月收治的11例基底节区脑脓肿并发脑疝患者的手术方法及其预后。结果:11例基底节区脑脓肿并发脑疝患者接受开颅去骨瓣减压加脓肿穿刺抽出术,其中10例治愈,且肢体功能都恢复正常;1例基底节区脑脓肿并发脑疝同时破入脑室患者,行开颅去骨瓣减压加脓肿穿刺抽出术的同时行脑室外引流术,术后10d死亡。结论:去骨瓣减压加脓肿穿刺抽出术是治疗基底节区脑脓肿并发脑疝有效的方法,且避免了基底节区重要结构(如内囊)的损伤。一旦脓肿破入脑室,则预后较差。Aim. To evaluate the operation and prognosis of brain abscesses in basal ganglia with cerebral herniation. Methods. 11 cases of brain abscesses in basal ganglia with cerebral herniation from Jan. of 2002 to Jun. of 2007 were analyzed, in which 1 case with intraventricular rupture of brain abscesses （IVRBA）. Results. Ten cases of brain abscesses in basal ganglia with cerebral herniation recovered well and the neurological deficits also recovered completely by decompressive craniectomy and aspiration. One case with IVRBA was dead 10 days late by decompressive craniectomy and external ventricular drainage. Conclusion： Decompressive craniectomy and aspiration could be regarded as an effective intervention to brain abscesses in basal ganglia with cerebral herniation. The possibility of damage to vital cerebral structure（internal capsule） could be avoided, while the prognosis of IVRBA was disappointed.

关 键 词：脑脓肿 基底节 脑疝 预后 

分 类 号：R742.7[医药卫生—神经病学与精神病学]