中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2015年
10期
848-850
,共3页
胆脂瘤,中耳%脑脓肿%穿刺抽液术%外科手术,计算机辅助
膽脂瘤,中耳%腦膿腫%穿刺抽液術%外科手術,計算機輔助
담지류,중이%뇌농종%천자추액술%외과수술,계산궤보조
Cholesteatoma,middle ear%Brain abscess%Paracentesis%Surgery,computer-assisted
目的 探讨影像导航辅助下耳源性脑脓肿穿刺引流术的操作技术及疗效.方法 回顾性分析2010年5月至2013年10月4例在影像导航辅助下行穿刺引流术的耳源性脑脓肿患者的临床资料.4例患者均为男性,年龄21 ～59岁,其中25岁以下者3例.均有中耳胆脂瘤病史,脑脓肿均为单发,其中大脑颞叶脓肿3例,小脑脓肿1例.结果 3例颞叶脓肿患者采用颅骨钻孑孔穿刺引流术,1例小脑脓肿患者采用乳突腔穿刺引流术.4例患者在影像导航辅助下均一次穿刺成功,抽出脓液6～15 ml不等.患者病情稳定、影像学显示脓腔闭合后,行乳突中耳手术彻底清除胆脂瘤病灶.穿刺脓液细菌培养3例有细菌生长,包括金黄色葡萄球菌、缓症链球菌、变形杆菌各1例.4例患者均痊愈,无并发症.术后随访1年,乳突腔上皮化良好.结论 影像导航辅助下脑脓肿穿刺引流术具有定位准确、创伤小、手术时间短、安全性高等特点,可根据患者病情需要酌情选择.
目的 探討影像導航輔助下耳源性腦膿腫穿刺引流術的操作技術及療效.方法 迴顧性分析2010年5月至2013年10月4例在影像導航輔助下行穿刺引流術的耳源性腦膿腫患者的臨床資料.4例患者均為男性,年齡21 ～59歲,其中25歲以下者3例.均有中耳膽脂瘤病史,腦膿腫均為單髮,其中大腦顳葉膿腫3例,小腦膿腫1例.結果 3例顳葉膿腫患者採用顱骨鑽孑孔穿刺引流術,1例小腦膿腫患者採用乳突腔穿刺引流術.4例患者在影像導航輔助下均一次穿刺成功,抽齣膿液6～15 ml不等.患者病情穩定、影像學顯示膿腔閉閤後,行乳突中耳手術徹底清除膽脂瘤病竈.穿刺膿液細菌培養3例有細菌生長,包括金黃色葡萄毬菌、緩癥鏈毬菌、變形桿菌各1例.4例患者均痊愈,無併髮癥.術後隨訪1年,乳突腔上皮化良好.結論 影像導航輔助下腦膿腫穿刺引流術具有定位準確、創傷小、手術時間短、安全性高等特點,可根據患者病情需要酌情選擇.
목적 탐토영상도항보조하이원성뇌농종천자인류술적조작기술급료효.방법 회고성분석2010년5월지2013년10월4례재영상도항보조하행천자인류술적이원성뇌농종환자적림상자료.4례환자균위남성,년령21 ～59세,기중25세이하자3례.균유중이담지류병사,뇌농종균위단발,기중대뇌섭협농종3례,소뇌농종1례.결과 3례섭협농종환자채용로골찬혈공천자인류술,1례소뇌농종환자채용유돌강천자인류술.4례환자재영상도항보조하균일차천자성공,추출농액6～15 ml불등.환자병정은정、영상학현시농강폐합후,행유돌중이수술철저청제담지류병조.천자농액세균배양3례유세균생장,포괄금황색포도구균、완증련구균、변형간균각1례.4례환자균전유,무병발증.술후수방1년,유돌강상피화량호.결론 영상도항보조하뇌농종천자인류술구유정위준학、창상소、수술시간단、안전성고등특점,가근거환자병정수요작정선택.
Objective To investigate the methods and results of imaging guided puncture and drainage in the treatment of otogenic brain abscess.Methods Reviewed and analyzed four cases of otogenic brain abscess treated by the technique of imaging guided puncture and drainage from May 2010 to October 2013, all of the four cases were male with age ranged from 21 years old to 59 years old, among whom three cases were under 25 years old.All patients had history of middle ear cholesteatoma and were found single brain abscess.Three cases were cerebrum abscess and one case was cerebellum abscess.Results The three cases with temporal lobe abscess received skull puncture drainage drilling, and one case with cerebellar abscess used the mastoid cavity puncture drainage.Four cases were punctured successfully in one time with the assistance of image navigation, 6-15 ml of pus was drainged out.After imaging showed pus cavity closure, middle ear surgery was performed to thoroughly remove cholesteatoma.The pus bacteria was cultured, which found three cases infected with staphylococcus aureus, Streptococcus mitis and proteusbacillus vulgaris respectively.The imaging showed brain abscess closed after once puncture drainage,four cases were cured without complications.Postoperative follow-up of one year with good mastoid cavity epithelialization.Conclusion Image guidance assisted puncture can drainage brain abscess with accurate positioning, less trauma, short operation time, and high safety, which could be choosen for otogenic abscess patient.
