耳源性脑脓肿14例临床分析  

Clinical analysis of 14 cases of otogenic brain abscess

作　　者：杨博[1] 张芳[2] 杨宁[1] 惠莲[1] 姜学钧[1] YANG Bo;ZHANG Fang;YANG Ning;HUI Lian;JIANG Xuejun(Department of Otolaryngology Head and Neck Surgery,First Affiliated Hospital of China Medical University,Shenyang,Liaoning,110001,China;Department of Otolaryngology Head and Neck Surgery,Fourth Affiliated Hospital of China Medical University,Shenyang,Liaoning,110032,China)

机构地区：[1]中国医科大学附属第一医院耳鼻咽喉头颈外科,辽宁沈阳110001 [2]中国医科大学附属第四医院耳鼻咽喉头颈外科,辽宁沈阳110032

出　　处：《中国耳鼻咽喉头颈外科》2019年第10期548-552,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨耳源性脑脓肿的临床特点及治疗。方法回顾性分析2011年8月~2017年9月于中国医科大学附属第一医院收治的耳源性脑脓肿患者的临床病例资料,总结其临床特点及治疗。结果所有患者中3例脑脓肿经抗炎治疗治愈,8例行开颅脑脓肿切除术,3例行钻孔引流术。13例行耳部手术。14例患者中13例患者治愈,治愈率92.9%,随访10个月~3年,未出现脑脓肿及耳部疾病复发。1例患者脑脓肿术后病情加重转回当地治疗失访。结论耳源性脑脓肿好发于颞骨胆脂瘤。对于有中耳炎急性发作病史,持续头痛,影像学提示骨质破坏的病例应高度怀疑脑脓肿等颅内并发症的可能。尽早发现脑脓肿并针对性的治疗是治愈的关键。OBJECTIVE To study the clinical feature and treatment of otogenic brain abscess. METHODS The medical records of 14 patients who were diagnosed with otogenic brain abscess between August 2011 and September 2017 were retrospectively reviewed. RESULTS Of the 14 patients, 3 cases were cured by conservative treatment, 8 cases were treated with craniotomy abscess resection, and 3 cases were treated with burr hole drainage. Thirteen patients accepted operation to remove the primary ear lesions.Thirteen of the 14 cases were cured, with a cure rate of 92.9%. The 13 cured patients were followed up for 10 months to 3 years without recurrence of brain abscess and ear disease. CONCLUSION Otogenic brain abscess often occurs in temporal bone cholesteatoma. For patients with attack of acute otitis media, persistent headache, and imaging findings of bone destruction, the possibility of intracranial complications such as brain abscess should be highly suspected. Early detection and targeted treatment is the key to cure brain abscess.

关 键 词：胆脂瘤 脑脓肿 临床方案 

分 类 号：R65[医药卫生—外科学]