【摘要】 目的总结目前脑脓肿的临床特点及其疗效。方法对90例脑脓肿患者的完整资料进行回顾性分析。结果本组脓肿构成比为细菌性脓肿97%,霉菌性脓肿2%,包虫性脓肿1%;细菌培养阳性率为10%,仅有1例CSF培养阳性;多发脑脓肿的治疗效果较单发脑脓肿差,两者比较差异有统计学意义(P<0.01);儿童组和成人组总体疗效差异无统计学意义(P>0.05);鞘内注射联合静滴抗生素疗效与单纯静脉用药差异无统计学意义(P>0.05);脑脓肿的抗菌治疗以三联抗生素即头孢三代+万古霉素+甲硝唑为主,临床有效率达88%(79/90)。结论目前脑脓肿细菌培养阳性率低,对细菌培养阴性者静脉给予头孢三代+甲硝唑+万古霉素是治疗脑脓肿的理想方法。更多还原

【Abstract】 Objective To investigate the clinical features and effect of intracerebral abscess in present series.Methods Ninety consecutive patients with brain abscess were studied restrospectively.Results Brain bacterial abscess in current cases was accouted for 97%,the intracranial fungal abscess and cerebral alveolar echinococcosis were 2% and 1% respectively.The positive rate of bacterium culture in present series was 10%,only one patient with positive bacterium in CSF.The poor outcome was notably observed in multi-brain abscess than that in solomn brain abscess(P<0.01).There was no significant difference between pediatric group and adult group(P>0.05),differences were similarly not found in the treatment of intraventricular injection,combined with venous administration,compared with mere venous administration(P>0.05).The clinical effect of three kinds of antibiotic regimens with tertiary-generation cephalosporin,vancomycin and metronidazole for brain abscess was 88%.Conclusion The positive rate of bacterium culture in present series is very low,emperial treatment with tertiary-generation cephalosporin,vancomycin and metronidazole for no evidence of positive bacterium in brain abscess are strongly recommend,however,treatment with intraventricular injection combined with venous administration fails to change the prognosis of intracerebral abscess.更多还原