神经导航辅助下穿刺抽吸治疗儿童脑脓肿的疗效及预后因素分析  

Clinical efficiency evaluation and prognostic factors of aspiration guided by neuronavigation to treat pediatric brain abscess

作　　者：王蒙[1] 赵毅 赵培超[1] 张鹏[1] 潘圆圆 李天豪[1] 刘学友[1] 王泽明[1] 邱成茗 张仁德 孙红卫[1] Wang Meng;Zhao Yi;Zhao Peichao;Zhang Peng;Pan Yuanyuan;Li Tianhao;Liu Xueyou;Wang Zeming;Qiu Chengming;Zhang Rende;Sun Hongwei(Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Translational Medicine Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Medicine,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经外科,450052 [2]郑州大学第一附属医院转化医学中心,450052 [3]郑州大学第三附属医院医务部,450052

出　　处：《中华实用儿科临床杂志》2021年第11期865-869,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金(81903448)。

摘　　要：目的探讨神经导航辅助下穿刺抽吸治疗儿童脑脓肿(PBA)的疗效及预后因素。方法回顾性分析郑州大学第一附属医院2013年1月至2019年1月经神经导航辅助下穿刺抽吸治疗的47例PBA患儿的临床资料。根据格拉斯哥预后评分结果评估手术疗效,将患儿分为预后良好组和预后不良组,对2组患儿的预后因素进行单因素分析和二分类Logistic回归模型多因素分析。结果47例患儿中预后良好38例(80.9%),预后不良9例(19.1%)。单因素分析显示,脓肿体积>4 cm(χ^(2)=5.650,P=0.017)、多发/多房型脓肿(χ^(2)=3.258,P=0.027)、脓肿位于脑深部/功能(χ^(2)=6.187,P=0.013)与PBA预后不良有关。多因素Logistic回归分析显示,脓肿体积>4 cm(OR=5.913,95%CI:2.241~25.917,P=0.023)、脓肿位于脑深部/功能(OR=10.519,95%CI:3.918~62.513,P<0.001)为PBA预后不良的独立危险因素。结论神经导航辅助下穿刺抽吸治疗PBA安全、有效、创伤小,总体疗效满意。脓肿体积>4 cm、脓肿位于脑深部/功能区是预后不良的独立危险因素。Objective To explore the clinical efficiency evaluation and prognostic factors of aspiration guided by neuronavigation in the treatment of pediatric brain abscess(PBA).Methods A total of 47 patients with PBA were treated with aspiration guided by neuronavigation between January 2013 and January 2019 at the First Affiliated Hospital of Zhengzhou University.All clinical data were retrospectively analyzed.According to Glasgow Outcome Scale on discharge,all children were divided into 2 groups,namely good prognosis group and poor prognosis group.Prognostic factors were analyzed by using univariate analysis and binary Logistic regression multivariate analysis.Results Among the 47 children,38 children(80.9%)were assigned to the good prognosis group,and 9 children(19.1%)were assigned to the poor prognosis group.Univariate analysis proved that abscess volume>4 cm(χ^(2)=5.650,P=0.017),multiple or multilocular abscess(χ^(2)=3.258,P=0.027),and abscess located in functional areas(χ^(2)=6.187,P=0.013)were correlated with poor prognosis.Multivariate analysis revealed that abscess volume>4 cm(OR=5.913,95%CI:2.241-25.917,P=0.023)and abscess located in functional areas(OR=10.519,95%CI:3.918-62.513,P<0.001)were independent risk factors for poor prognosis.Conclusion The treatment of PBA with aspiration guided by neuronavigation is safe,effective and minimal invasive,and the clinical efficiency is satisfactory.Abscess volume>4 cm and abscess located in deepbrain/functional areas are independent risk factors for poor prognosis.

关 键 词：脑脓肿 神经导航 穿刺抽吸 儿童 预后因素 

分 类 号：R742.7[医药卫生—神经病学与精神病学]