CT导向微创穿刺自制微泵控制持续冲洗引流治疗脑脓肿的临床研究

目的研究脑脓肿的微创治疗新方法. 资料与方法采用医用高分子材料制造的带可储存药物胶囊的可控微泵,与北京万特福公司生产的YL-Ⅰ型血肿粉碎穿刺针连接.在CT导引下对33例脑脓肿行微创穿刺药物持续灌注治疗. 结果本组33例,31例一次引流治愈,其中7例多房性脓肿作两点穿刺同时冲洗引流,治愈率为93.9%;1例小脑厚壁脓肿,经引流症状改善后行脓肿切除;另1例因败血症合并癫痫持续状态而死亡,死亡率为3%.32例随访3个月～4年,平均2年4个月,均无脓肿复发,仅有1例仍留有轻度肢体运动障碍. 结论 CT导向微创穿刺自制微泵控制持续冲洗引流治疗脑脓肿操作简单、安全有效,可成为大多数脑脓肿的首选治疗方法.

CT-guiding Stereotactic Aspiration and Drainage of Brain Abscess

Objective To study a new way of microinvasive treatment of brain abscess. Materials and Methods 33 cases with brain abscess underwent CT-guiding stereotatic aspiration and continuous drainage. The controllable micropump apparatus was made of high molecule materials with stored drugs. Results 31 cases were cured with one drainage and 7 cases with multiple-room abscess were cured in two puncture points. The cure rate was 93.9%. One case with thick-wall abscess of cerebrallum was resected after drainage. One case died of septicaemia and epilepsy and the death rate was 3%. 32 cases were followed up from 3 months to 4 years with the average 2.4 months. None recurred except only one with mild extremity paralysis postoperative. Conclusion Stereotatic aspiration and continuous drainage are simple, safe and accurate methods for brain abscess. When combined with the proper antibiotics, it should be considered the procedure of choice in the management of brain abscesses.