隐源性脑脓肿16例临床分析  

Cryptogenic Brain Abscess:a Report of 16 Cases

作　　者：王卫民[1] 肖国民[1] 裘五四[1] 姜启周[1] 程军[1] 吴建跃[1] 

机构地区：[1]杭州师范大学医学院附属医院神经外科,浙江杭州310015

出　　处：《中华医院感染学杂志》2009年第22期3059-3060,共2页Chinese Journal of Nosocomiology

摘　　要：目的探讨隐源性脑脓肿的临床诊断及治疗问题。方法分析1997年1月-2008年3月医院收治的16例病原学来源不明确、病程表现不典型的脑脓肿患者。结果13例手术患者脓液培养出金黄色葡萄球菌4株、酿脓链球菌3株、大肠埃希菌2株、肺炎克雷伯菌1株;治愈15例,自动出院1例,治愈病例除1例老年患者轻偏瘫外,其余恢复均良好。结论隐源性脑脓肿临床表现呈非特异性,以革兰阳性菌感染为主,老年人比例高;及时明确诊断及治疗,预后良好,手术以穿刺引流为首选,小型脑脓肿抗菌药物保守治疗也可治愈。OBJECTIVE To study the clinical diagnosis and treatment of cryptogenic brain abscess. METHODS Sixteen cases with brain abscess of unknown sources of infection during the past 11 years were analyzed. RESULTS Of 16 patients, 13 patients got bacterial culture,and showed staphylococcus asepsis in 4 cases,Streptococcus pyogenes in 3 cases,Escherichia coli in 2 cases,Klebsiella pneumoniac in 1 case and aseptic growth in 3 cases,Fifteen cases were cured, 1 case died of multiple organs function failure. Of cured cases , the exception of 1 case of elderly patients have had muscle strength slightly worse in the side of the distal limb, the remaining cases were good. CONCLUSIONS The clinical manifestations of cryptogenic brain abscess are not typical. The abscess could be more common in elderly than younger. To timely diagnose and treat, the prognosis is good. Abscess puncture and drainage are the first choice. Small brain abscess could be cured by conservative treatment of antibiotics.

关 键 词：脑脓肿 隐源性 诊断 治疗 

分 类 号：R181.32[医药卫生—流行病学]