后颅窝肿瘤术后仅合并颅内感染的临床特点及抗菌药物治疗分析

发布时间：2018-04-22 18:07

本文选题：后颅窝肿瘤 + 颅内感染　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的探讨后颅窝肿瘤术后仅合并颅内感染的早期临床特点及抗菌药物治疗效果。方法回顾性分析重庆医科大学附属第一医院神经外科2014年3月至2016年3月显微神经外科手术治疗的后颅窝肿瘤患者195例,依据术后仅合并颅内感染的纳入排除标准,分析早期颅内感染的临床特点、脑脊液(cerebrospinal fluid,CSF)检查结果。依据不同时期经验性抗感染治疗药物分成碳青霉烯类组和联合用药组(碳青霉烯类+万古霉素),比较两组治疗效果。结果共计纳入26例,术后平均发热时间为(6.2±3.7)d,经验性抗感染治疗时间为(7.1±3.4)d,首次腰椎穿刺时间为(7.9±3.5)d,CSF有核细胞数高峰期为(10.2±3.3)d,首次和高峰期有核细胞数分别为(665.4±324.6)×106/L、(1935.1±1437.3)×106/L,后者较首次明显升高(P0.05)。CSF培养阳性5例,以Gˉ菌为主,单用碳青霉烯类组治疗时间(16.6±7.7)d,联合用药组治疗时间(15.5±4.8)d,两组差异无统计学意义(P0.05)。结论后颅窝肿瘤术后颅内感染早期临床特点无特异性,且CSF培养阳性率低,术后疑似颅内感染,需多次CSF检查,尽早经验性使用抗Gˉ菌药物。
[Abstract]:Objective to investigate the early clinical features of intracranial infection after operation of posterior cranial fossa tumor and the therapeutic effect of antimicrobial agents. Methods 195 patients with posterior cranial fossa tumor treated by microneurosurgery from March 2014 to March 2016 in the first affiliated Hospital of Chongqing Medical University were retrospectively analyzed. To analyze the clinical features of early intracranial infection and the results of cerebrospinal fluid cerebrospinal fluid (CSF) examination. According to the experience of different period of anti-infective treatment drugs were divided into carbapenem group and combination group (carbapenem vancomycin group) and compared the therapeutic effects between the two groups. Results A total of 26 cases were included, The average postoperative fever time was 6.2 卤3.7 days, the time of empirical anti-infective therapy was 7.1 卤3.4 days, the first lumbar puncture time was 7.9 卤3.5 d, the peak number of nucleated cells in CSF was 10.2 卤3.3 d, and the number of nucleated cells in the first and peak periods were 665.4 卤324.6 脳 10 6 / L, 1935.1 卤1437.3) 脳 10 6 L, respectively. The treatment time was 16.6 卤7.7 days in the carbapenem group and 15.5 卤4.8 days in the combined treatment group. There was no significant difference between the two groups (P 0.05). Conclusion the early clinical features of intracranial infection after operation of posterior cranial fossa tumor are not specific, and the positive rate of CSF culture is low. The suspected intracranial infection after operation should be examined by CSF many times, and the anti-G bacteria drug should be used empirically as soon as possible.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.4

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