立体定向Ommaya囊置入术联合序贯抗感染治疗隐源性脑脓肿的研究  

Study of stereotactic Ommaya bag implantation combined with sequential anti-infective therapy in the treatment of cryptogenic brain abscess

作　　者：邵志辉 李维方[1] 裘五四[2] 吴建跃[2] 程军[2] 袁云鹏[2] 姜启周[2] 肖国民[2] 冯斌[3] 孟艳林[3] 

机构地区：[1]杭州师范大学附属医院功能神经外科,浙江杭州310015 [2]杭州师范大学附属医院神经外科,浙江杭州310015 [3]解放军第251医院神经外科,河北张家口075000

出　　处：《中华医院感染学杂志》2016年第12期2764-2766,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅医药卫生计划基金项目资助(2013RCA038)

摘　　要：目的探讨立体定向Ommaya囊置入术联合序贯抗感染治疗隐源性脑脓肿的临床疗效,为临床对隐源性脑脓肿的治疗提供有效依据。方法随机选取2012年8月-2015年8月医院收治的96例隐源性脑脓肿患者,依据随机数字表法将其分为研究组和对照组,各48例,对照组患者给予内科保守治疗,研究组患者给予立体定向Ommaya囊置入术联合序贯抗感染治疗,统计分析两组患者的临床疗效、治疗后不良反应发生率。结果研究组患者无感染发生,对照组患者有2例发生感染,感染率4.2%;研究组患者治疗总有效率为93.8%,高于对照组患者的72.9%,差异有统计学意义(P<0.05);对照组患者并发症、不良反应发生率分别为12.5%、8.3%,研究组患者分别为6.3%、4.2%,与对照组相比,研究组患者的并发症及不良反应发生率显著较低,差异有统计学意义(P<0.05)。结论立体定向Ommaya囊置入术联合序贯抗感染治疗隐源性脑脓肿较内科保守治疗,更能显著提高对患者治疗的总有效率,同时有效减少患者的不良反应,具有较高的有效性及安全性,值得在临床推广。OBJECTIVE To investigate the clinical effects of stereotactic Ommaya bag implantation combined with sequential anti-infective therapy in the treatment of cryptogenic brain abscess,so as to provide an effective basis for the clinical treatment of cryptogenic brain abscess.METHODS A total of 96 cases of patients with cryptogenic brain abscess in our hospital from Aug.2012 to Aug.2015 were randomly selected,and divided into two groups according to the random number table,including study group（n=48）and control group（n=48）.The patients of control group were given conservative treatment,while the patients of study group were given stereotactic Ommaya bag implantation combined with sequential anti-infection treatment,and then the clinical efficacy,the occurrence of adverse reactions after treatment of the two groups of patients were analyzed.RESULTS There were no infection in patients of study group,and 2cases of infection in patients of control group,with infection rate of4.2%.The total efficacy rate of patients in study group was 93.8%,significantly higher than 72.9% of control group（P〈0.05）;The complication rates and adverse reaction rates of patients in control group and study group were 12.5%,12.5% and 6.3%,4.2%,respectively.Compared with control group,the complication rate and adverse reaction rate of study group were significantly lower（P〈0.05）.CONCLUSIONStereotactic Ommaya bag implantation combined with sequential anti-infective therapy in the treatment of cryptogenic brain abscess is more significantly in improving the overall efficacy of patients than conservative treatment,while effectively reduce adverse reactions of patients,and it has higher availability and security,so is worthy of promotion in the clinical.

关 键 词：立体定向Ommaya囊置入术 序贯抗感染治疗 隐源性脑脓肿 

分 类 号：R512.3[医药卫生—内科学]