CAJ | 학술논문

目的探讨多房性脑脓肿(MLPBA)患者的临床特征和治疗选择.方法回顾性分析海军总医院神经外科自1991年至2011年收治的20例MLPBA和69例单房性脑脓肿(ULPBA)患者的临床资料并进行统计学处理.结果本组MLPBA患者占全部脑脓肿患者的22.5％,2组间患者性别比例、年龄分布、病程时间、脓肿部位、细菌类型、感染途径和临床表现差异无统计学意义(P＞0.05); MLPBA组的细菌培养阳性率和破人脑室率高于ULPBA组,MLPBA和ULPBA的平均脓肿体积分别为8.8 mL和13.3 mL.MLPBA和ULPBA的立体定向治疗复发率分别为26.7％和3.2％,死亡率分别为0％和4.3％.结论 MLPBA并非少见;其脓肿体积小于ULPBA但更易破入脑室;立体定向脓肿穿刺为第一治疗选择;虽有些患者需重复立体定向手术治疗,但总体预后良好.
목적 탐토다방성뇌농종(MLPBA)환자적림상특정화치료선택.방법 회고성분석해군총의원신경외과자1991년지2011년수치적20례MLPBA화69례단방성뇌농종(ULPBA)환자적림상자료병진행통계학처리.결과 본조MLPBA환자점전부뇌농종환자적22.5％,2조간환자성별비례、년령분포、병정시간、농종부위、세균류형、감염도경화림상표현차이무통계학의의(P＞0.05); MLPBA조적세균배양양성솔화파인뇌실솔고우ULPBA조,MLPBA화ULPBA적평균농종체적분별위8.8 mL화13.3 mL.MLPBA화ULPBA적입체정향치료복발솔분별위26.7％화3.2％,사망솔분별위0％화4.3％.결론 MLPBA병비소견;기농종체적소우ULPBA단경역파입뇌실;입체정향농종천자위제일치료선택;수유사환자수중복입체정향수술치료,단총체예후량호.
Objective To investigate the clinical characteristics and treatment choice of patients with multiloculated pyogenic brain abscess (MLPBA).Methods The clinical data of 89 patients with pyogenic brain abscess (including 20 with MLPBA and 69 with uniloculated pyogenic brain abscess [ULPBA]) treated during the recent 21 years (1991-2011) were collected and analyzed retrospectively.Results MLPBA patients counted for 22.5％ of our patients with pyogenic brain abscess.The male-female ratio,age distribution,history duration,location of abscess,kinds of isolated microorganisms,predisposing factors and clinical manifestations of patients with MCPAB were similar to those of patients with ULPBA.The ratio of positive isolated microorganism and ratio breaking into ventricles in patients with MLPBA were significantly higher than those in patients with ULPBA (P＜0.05); and the average volume of abscess was 8.8 mL in patients with MLPBA and 13.3 mL in patients with ULPBA.A higher rate of abscess recurrence after stereotactic surgery in patients with MLPBA (26.7％) was found as compared with that in patients with ULPBA (3.2％).The mortality in patients with MLPBA was 0％ and that in patients with ULPBA was 4.3％.Conclusion MLPBA is not rare; the volume of abscess in patients with MLPBA is significantly smaller than that in patients with ULPBA,but the abscess in patients with MLPBA is significantly easier broken into the ventricles than that of ULPBA.Stereotactic operation is the first treatment choice; the prognosis for patients with MLPBA can be as good as that for patients with ULPBA,although the possibility of recurrent abscess formation after surgery is higher.