神经外科术后颅内感染的治疗方法分析  

Analysis the Treatment of Intracranial Infection Following Neurosurgical Operation

作　　者：沈伟锋[1] 王雪新[1] 王洪正[1] 冯文峰[2] 黄胜平[2] 漆松涛[2] 

机构地区：[1]广东省惠州市惠阳区人民医院神经外科,广东惠阳516211 [2]广州市南方医院神经外科,广东广州510515

出　　处：《中外医疗》2009年第9期9-11,共3页China & Foreign Medical Treatment

摘　　要：目的分析神经外科术后颅内感染的治疗方法,以提高疗效、改善预后。方法对2003年1月至2008年5月期间本文作者收治的31例神经外科术后颅内感染病例进行回顾性分析。其中单纯静脉输注抗生素进行抗感染治疗5例;在静脉使用抗生素的同时,选择性地进行鞘内注射抗生素8例,脑脊液置换+鞘内注射抗生素4例,腰大池置管引流+鞘内注射抗生素10例,CSF鼻漏并发颅内感染4例者行手术修补+静脉抗生素治疗。药物选择:罗氏芬8例,罗氏芬+稳可信23例。结果临床治愈30例,死亡1例。讨论本组方法对治疗神经外科术后颅内感染的疗效显著,但各种治疗方法之间存在互补关系,各有所长,其中以鞘内注射抗生素为首选,药物方面以稳可信的疗效最为肯定。Objective To study the treatment of intracranial infection following neurosurgical operation,so as to increase overall outcome and improve prognosis.Methods Between January 2003 and May 2008,31 cases of intracranial infection after craniaocerebral operation treated by antor were studied retrospectively.Five cases were treated only by intravenous administration antibiotics.Besides intravenous administration, 8 cases were managed by intrathecal injection of effective antibiotics, 4 by CSF permutation and intrathecal injection of antibiotics, 10 by continual drainage through lumbar subarachnoid cavity and intrathecal injection of drugs.Three infected patients after cerebrospinal rhinorrhea were treated by operation and intravenous administration of antibiotics. As to antibiotics, 8 cases were administrated by Ceftriaxone, 23 by Ceftriaxone and Vancomycin simultaneously. Results Thirty patients were cured clinically,with only one death.Conlusion We recommended intrathecal injection of antibiotics as the first choice to treat intracranial infection following neurosurgical operation,and Vancomycin is the most effective of all drugs.

关 键 词：颅内感染 鞘内注射 持续腰大池引流 脑脊液置换 

分 类 号：R251[医药卫生—中医内科学]