脑脓肿不同时期手术干预的疗效分析

发布时间：2018-03-21 00:54

本文选题：脑脓肿　切入点：脓肿引流术　出处：《中国临床神经外科杂志》2016年09期 　论文类型：期刊论文

【摘要】：目的探讨脑脓肿不同时期手术方法及其疗效。方法回顾性分析2010年1月~2015年12月收治的52例脑脓肿的临床资料,依据病理分期及手术方式分为4组:化脓期引流术组14例,化脓期切除术组13例,脓肿形成期引流术组10例,脓肿形成期切除术组15例。术后随访60 d,分析各组疗效、病死率、复发率及术后住院天数、神经症状缓解时间。结果 4组性别比、年龄分布、入院GCS评分无明显差异(P0.05)。脓肿形成期切除术组中位住院天数较脓肿形成期引流术组明显延长(P0.05),而与化脓期引流术组、化脓期切除术组均无明显差异(P0.05)。化脓期引流术组病死率明显高于其他3组(P0.05)。4组术后复发率均无明显差异(P0.05)。脓肿形成期切除术组中位神经症状缓解时间最短(P0.05)。结论脓肿形成期引流术后住院天数较长,但神经症状缓解较快;化脓期出现脑疝征象时,应积极手术干预,必要时行去骨瓣减压术。
[Abstract]:Objective to investigate the operative methods and curative effect of brain abscess at different stages. Methods the clinical data of 52 cases of brain abscess from January 2010 to December 2015 were retrospectively analyzed. According to the pathological stages and surgical methods, the patients were divided into 4 groups: 14 cases in the drainage group during purulent period. There were 13 cases in the purulent resection group, 10 cases in the drainage group during abscess formation, and 15 cases in the abscess formation stage resection group. All patients were followed up for 60 days, and the curative effect, mortality, recurrence rate and postoperative hospitalization days were analyzed. Results there was no significant difference in sex ratio, age distribution and admission GCS score among the four groups. The median length of stay in the abscess formation stage group was significantly longer than that in the abscess stage drainage group, but it was significantly longer than that in the suppurative drainage group. There was no significant difference in the postoperative recurrence rate in the purulent resection group (P 0.05). The mortality of the drainage group was significantly higher than that in the other three groups (P 0.054.There was no significant difference in postoperative recurrence rate between the two groups. Conclusion the median neurologic symptom relief time in the abscess formation stage resection group is the shortest (P 0.05). The length of hospital stay after drainage during abscess formation was longer. But the neurological symptoms were relieved more quickly, and when the symptoms of cerebral hernia appeared in the stage of pyosis, the operative intervention should be actively carried out, and the decompression of bone flap should be performed when necessary.
【作者单位】：新疆医科大学第一附属医院神经外科;
【基金】：新疆维吾尔自治区青年科技人才专项科研项目(2015Y35)
【分类号】：R651.1

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