儿童颅内外沟通巨大皮样囊肿合并颅内感染的诊治分析  

Diagnosis and treatment of giant dermoid cyst with intra-and extracranial extension associated with intracranial infection in children(report of 8 cases)

作　　者：裴航 赵春丽 吕强[1] 李涛[1] 齐林[1] PEI Hang;ZHAO Chun-li;Lü Qiang;LI Tao;QI Lin(Department of Neurosurgery,Children's Hospital Affiliated of Zhengzhou University/Henan(Zhengzhou)Children's Hospital,Zhengzhou 450000,China;Department of Pharmaceutical and Regulatory Affairs,Zhengzhou Second Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院/河南省儿童医院/郑州儿童医院神经外科,郑州450000 [2]郑州市第二人民医院药务科,450000

出　　处：《中国临床神经外科杂志》2020年第9期584-586,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨儿童颅后窝中线部位颅内外沟通巨大皮样囊肿继发颅内感染的诊治方法及治疗效果。方法回顾性分析2016~2020年收治8例颅后窝中线部位、颅内外沟通巨大皮样囊肿继发颅内感染的临床资料。结果8例均有头皮窦道、经颅骨及硬脑膜缺损使颅内外皮样囊肿相沟通,并继发颅内感染。首选敏感抗菌素控制感染达标后,开颅手术治疗,囊肿完整切除7例,顺利治愈,术后3周内出院;1例因囊壁炎症性浸润,分离时囊壁破裂,内容物外溢,全切囊肿后,反复温生理盐水冲洗,术后发生无菌性脑膜炎、延迟2个月治愈出院。全部患儿至少随访3个月,未见复发。结论儿童颅后窝中线部位颅内沟通的皮样囊肿易反复继发颅内感染,应尽早诊断,首选敏感抗菌素控制感染后手术完整切除颅内外沟通的皮样囊肿,可取得良好效果。Objective To explore the clinical characteristics,and treatment methods and outcomes of giant dermoid cyst with intra-and extracranial extension associated with intracranial infection in children.Methods The clinical data of 8 children with giant dermoid cyst with intra-and extracranial extension associated with intracranial infection who were admitted to our hospital from 2016 to2020 were retrospectively analyzed.Results All the 8 children had cranial sinus,skull and dural defect,which caused intracranial cyst to communicate with the extracranial cyst and secondary intracranial infection.After the infection was controled by sensitive antibiotics,craniotomies were performed in 8 children,of whom,7 children had complete removal of the cysts and were discharged within 3 weeks after the operation,and 1 children had rupture of the cyst due to the cyst wall inflammatory infiltration which casued aseptic meningitis and was discharged 2 months after the operation.All the children were followed up for at least 3 months and no recurrence was found.Conclusions The dermoid cysts with intra-and extracranial extension in the middle line of the posterior cranial fossa in children are prone to recurrent intracranial infection and should be diagnosed as soon as possible.The first choice is completely removing the dermoid cyst after control the infection by sensitive antibiotics,which can obtain good outcomes.

关 键 词：皮样囊肿 颅内外沟通肿瘤 颅内感染 显微手术 儿童 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]