CAJ | 학술논문

目的探讨脑脓肿临床特点、治疗、相关危险因素与预后,为临床治疗及预防提供依据.方法回顾分析2005年1月和2014年2月我科收治的47例手术联合药物治疗脑脓肿患者的临床资料、治疗方案、相关危险因素与预后分析.结果本组47例患者,头痛37例(79%),意识障碍15例(36%),发热19例(40%),癫痫13例(28%),运动障碍17例(36%),35例(74%)有明确诱发因素,细菌培养阳性7例(14%),金黄色葡萄球菌4例(57%),链球菌3例(43%),二者是最常见的致病菌.CT定位穿刺抽吸术38例(81%),开颅脑脓肿切除术9例(19%),其中3例死亡(6%).结论患者原发疾病,诱发因素,入院时意识障碍程度和脓肿是否破入脑室是决定预后的重要因素,GCS评分越低,免疫力抑制,HIV,糖尿病患者,预后越差.早期诊断,根治原发病和立体定向穿刺引流术联合抗感染治疗明显改善患者预后.
목적 탐토뇌농종림상특점、치료、상관위험인소여예후,위림상치료급예방제공의거.방법 회고분석2005년1월화2014년2월아과수치적47례수술연합약물치료뇌농종환자적림상자료、치료방안、상관위험인소여예후분석.결과본조47례환자,두통37례(79%),의식장애15례(36%),발열19례(40%),전간13례(28%),운동장애17례(36%),35례(74%)유명학유발인소,세균배양양성7례(14%),금황색포도구균4례(57%),련구균3례(43%),이자시최상견적치병균.CT정위천자추흡술38례(81%),개로뇌농종절제술9례(19%),기중3례사망(6%).결론 환자원발질병,유발인소,입원시의식장애정도화농종시부파입뇌실시결정예후적중요인소,GCS평분월저,면역력억제,HIV,당뇨병환자,예후월차.조기진단,근치원발병화입체정향천자인류술연합항감염치료명현개선환자예후.
Objective The purpose of this study investigates the clinical characteristics, treatment, related risk factors and prognostic factors in patients with brain abscess. Methods The retrospectively analyzed the data in 47 patients with intracranial abscesses who combined surgical and medical approach,treatment plan and related risk factors and prognosis between January 2005 and February 2014. Results The study included 47 patients. At admission, 37 cases of headache (79%),15 cases patients (36%) showed either clear or mildly disturbed consciousness and fever 19 cases (40%), 13 cases of epilepsy (28%), dyskinesia of 17 cases (36%), 35patients (79%) had predisposing factors. The offending microorganisms were identifid in 7 patients (14%), and staphylococcus aureus 4 cases (57%), streptococcus 3 cases (43%), they are the most common pathogenic bacteria. Puncture pumping CT positioning technique 38 cases (81%), resection of cerebral abscess in 9 cases (19%), 3 cases died (6%). Conclusion We found that Patients with primary diseases, predisposing factor, the level of consciousness at admission and abscess is broken into the ventricle was associated with treatment outcomes in patients with brain abscesses. the lower the GCS score, immune suppression, HIV, diabetes result in the worse prognosis. Early diagnosis and cure the primary disease and stereotactic puncture drainage with anti-infection therapy significantly improve the prognosis of patients.