脑积水分流术后感染的外科治疗策略  

Surgical treatment strategy for cerebrospinal fluid shunt infection in patients with hy⁃drocephalus

作　　者：刘子源 陈天歌 陈思明 武海宇 罗湘颖[1] LIU Zi-Yuan;CHEN Tian-Ge;CHEN Si-Ming;WU Hai-Yu;LUO Xiang-Ying(Department of Neurosurgery,XiangYa Hospital of Central South University,Changsha,Hunan 410008,China)

机构地区：[1]中南大学湘雅医院神经外科,湖南长沙410008

出　　处：《国际神经病学神经外科学杂志》2021年第6期546-550,共5页Journal of International Neurology and Neurosurgery

摘　　要：对于脑积水分流术后感染,尽管已有一系列指南和共识推荐,不同医师给出的实际治疗策略仍然有很大差异。相当比例的医师会出于各种考虑进行保守治疗。笔者汇报1例分流感染、腹腔端阻塞而行保守治疗的患者,初始因考虑抗生素治疗有效,仅行处理分流管腹腔端阻塞的手术,后因感染控制不佳而行长通道脑室外引流,彻底控制感染后重新行脑室心房分流术。分享该病例旨在阐明分流感染治疗决策的复杂性,简要讨论保守治疗的可能性,并介绍用于安全廓清感染性脑脊液的长通道脑室外引流技术。Although various guidelines and consensus statements have been developed for cerebrospinal fluid(CSF)shunt infection in patients with hydrocephalus,there are still great differences in the actual treatment strategy given by different clinicians. A considerable proportion of clinicians may choose conservative treatment for various reasons. This article reports a patient who received conservative treatment due to shunt infection and shunt tube occlusion at the abdominal end.Since initial antibiotic therapy seemed effective,the patient only received laparoscopic correction of shunt tube occlusion at the abdominal end,followed by long-channel external ventricular drainage due to poor control of infection,and ventricleatrium shunt was performed again after infection was controlled completely. This case is shared to clarify the complexity of treatment decision-making regarding shunt infection,briefly discusses the possibility and feasibility of conservative management,and introduces the technique of long-channel external ventricular drainage for safe clearance of infectious CSF.

关 键 词：脑积水 脑室腹腔分流术 颅内感染 长通道脑室外引流 

分 类 号：R651.1[医药卫生—外科学]