耳源性脑脓肿一例并文献复习  

Otogenic Brain abscess A Case Report and Literature review

作　　者：周杨 代学忠 崔理明 李颖月 邓芳 鲍学钰 张睿哲 Zhou Yang;Dai Xuezhong;Cui Liming;Li Yingyue;Bao Xueyu;Deng Fang;Zhang Ruizhe(Department of Otolaryngology and Head and Neck Surgery,The Third People’s Hospital of Yunnan Province,Kunming 650011,Yun Nan Province,China)

机构地区：[1]云南省第三人民医院,云南昆明650011

出　　处：《中国医学文摘（耳鼻咽喉科学）》2023年第6期143-145,I0002,F0003,共5页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：耳源性脑脓肿作为耳科感染最严重的危及生命的并发症之一,故汇报我科近来收治的耳源性脑脓肿病例并复习文献,描述常见的临床体征和症状、细菌学、位置、治疗方案,分享相关体会。耳源性脑脓肿患病率低,但死亡率高。大多有化脓性中耳炎病史或中耳胆脂瘤,脓肿多位于颞叶,其次为小脑。常见症状是发热、头痛、精神状态改变、恶心、视乳头水肿和脑膜刺激征。常见培养细菌种类是变异形杆菌、链球菌、葡萄球菌。大多采用穿刺抽吸后置管引流并根据药敏继续静脉抗生素治疗。对于有慢性耳部疾病病史突然新发出现发热、头痛和恶心、精神状态改变等新症状的患者,耳鼻喉科医生应提高警惕,采取迅速、精准的诊断和治疗可以尽量降低患者的并发症和死亡率。Otogenic brain abscess is one of the most serious life-threatening complications of ear infection,so reports the recent cases of otogenic brain abscess in our department,reviews the literature,describes the common clinical signs and symptoms,bacteriology,location,treatment plan,and shares the relevant experience.Although the prevalence rate of otogenic brain abscess is low,the mortality rate is high.Otogenic brain abscess mostly has history of suppurative otitis media or middle ear cholesteatoma,abscess is located in temporal lobe more,followed by cerebellum.The common symptoms are fever,headache,altered mental status,nausea,papilledema and meningeal irritation.The common culture bacteria are mutants,streptococcus and staphylococcus.Most of the patients were treated by puncture aspiration followed by catheter drainage and continued intravenous antibiotic treatment according to drug sensitivity.For patients with a history of chronic ear disease who suddenly show new symptoms such as fever,headache and nausea,and mental state changes,otolaryngologists should be vigilant,and prompt and accurate diagnosis and treatment can reduce the complications and mortality of patients as much as possible.

关 键 词：耳源性脑脓肿 中耳炎 中耳胆脂瘤 

分 类 号：R65[医药卫生—外科学]