脑室出血多次外引流术致颅内感染并发脑积水的5例分析

目的脑室出血外引流术后并发感染和脑积水,在治疗上较为棘手,且预后不良。文中分析脑室出血外引流术后感染的原因和治疗方法。方法回顾分析5例脑室出血铸型患者的诊治过程。结果 5例患者均有2次以上手术史,1例为1次开颅术和1次脑室外引流术,另4例均有3次脑室外引流手术史,手术均在全身麻醉下进行。4例患者经脑室和腰大池引流、抗炎支持等治疗后感染控制,出现脑积水后行脑室腹腔分流,意识状态及神经功能均有好转,另1例感染未能控制死亡。结论反复多次脑室外引流是感染的原因之一,正确使用抗生素、充分的外引流和营养支持是十分关键的治疗方法。

Intracranial infection and hydrocephalus after repeated external ventricular hemorrhage drainage: Analysis of 5 cases

Objective Intracranial infection after external ventricular hemorrhage drainage is difficult to be managed and has a poor prognosis.This study was to discuss the causes of intracranial infection after external ventricular hemorrhage drainage and the methods for its treatment.Methods We retrospectively analyzed the treatment procedures of 5 cases of ventricular hemorrhage.Results Four of the patients thrice underwent external ventricular drainage,and the other 1 received craniotomy and external ventricular drainage,all under general anesthesia.The conscious status and nervous function were improved in 4 cases after ventricular and lumber cisterna drainage,infusion of antibiotics into the cisterna,and ventricle-peritoneal shunt against hydrocephalus,but 1 died of critical infection.Conclusion Repeated external ventricular drainage is one of the main causes of intracranial infection.External drainage,correct antibiotics,and nutritional support are important methods to control intracranial infection.