Ommaya囊置入外引流术在幼儿化脓性脑膜炎合并硬膜下积液治疗中的应用

目的探讨应用Ommaya囊置入外引流术治疗幼儿化脓性脑膜炎合并硬膜下积液的临床效果。方法2010年6月至2013年6月我们对38例化脓性脑膜炎合并硬膜下积液患儿，在抗感染治疗的同时，置入Ommaya囊持续外引流，观察临床症状的改善程度，并行头颅CT检查硬膜下积液吸收情况。结果28例患儿经持续引流5～7d后，发热、头痛及呕吐症状均明显减轻，又反复穿刺囊体3～6次并引流，2个月后复查头颅CT，提示29例硬膜下积液明显减少，9例无变化；术后1年复查，32例硬膜下积液消失，3例明显减少，3例因脑膜炎控制效果差，症状反复，放弃治疗。结论Ommaya囊可以长期置入，反复穿刺引流，较传统颅骨钻孔直接外引流，减少了感染风险，是治疗幼儿化脓性脑膜炎合并硬膜下积液的一种有效方法。

The application of Ommaya reservoir implanted external drainage in the treatment of infants purulent meningitis with subdural effusion

Objetive To study the clinical results about Ommaya reservoir implanted external drainage in the treatment of infants pundent meningitis with subdural effusion. Methods From June 2010 to June 2013 ,there were 38 cases pundent meningitis with subdural effusion adopted the anti-infection treatment and Ommaya reservoir implanted external drainage. The relief degree of clinical symptom was observed and the absorption state about subclural effusion was checked through cranial CT. Results 28 cases of children＇ s fever, headache and emesis symptoms had relieved by continuous drainage 5 -7 days, After repeated puncture 3 ~ 6 times and then through the drainage,the cranial CT showed 29 cases subdural effusion had reduced significantly after two months. 9 cases unchanged; 32 cases subdural effusion haddlsappeared in the postoperative one year, 3 cases had reduced significantly, but 3 cases abandoned treatment because the symptoms were not ease. Conclusion Ommaya reservoir can be punctured repeatedly and long time drainage. In comparison with the traditional methods of drilling skull external drainage, the Ommaya reservoir implanted external drainage reduced the risk of infection, this is a valid method to treat the infants purulent meningitis with subdural effusion.