硬膜外及硬膜下脓肿.PDF

-318- 中国临床神经外科杂志2017 年5 月第22 卷第5 期 Chin J Clin Neurosurg, May 2017, Vol. 22, No. 5 ● 论论 著著 ● 清创联合抗生素持续封闭冲洗引流术治疗开颅术后 硬膜外及硬膜下脓肿 周 健 陈谦学 【摘要】目的探讨开颅术后硬膜外及硬膜下脓肿的诊断及治疗方法。方法 回顾性分析18例采用清创联合抗生素持续封 闭冲洗引流术治疗的开颅术后硬膜外及硬膜下脓肿的临床资料。结果冲洗引流治疗6~10 d ，17例拔管后脓肿治愈；1例拔管后 发现脑内脓肿继续行脓肿穿刺引流后治愈。术后随访3~12 月，感染无复发。结论头颅CT/MRI 检查结果是诊断开颅术后硬膜 外及硬膜下脓肿的重要依据，采用清创联合抗生素持续封闭冲洗引流术治疗开颅术后硬膜外及硬膜下脓肿疗效良好。 【关键词】硬膜外脓肿；硬膜下脓肿；开颅手术；并发症；封闭冲洗引流术；清创手术 + 【文章编号】1009-153X（2017 ）05-0318-04 【文献标志码】A 【中国图书资料分类号】R 742.7; R 651.1 1 Applicationofdebridementandcontinuousclosedirrigationanddrainagetothetreatmentofepiduralandsubduralabscess aftercraniotomy ZHOUJian,CHENQianXue.DepartmentofNeurosurgery,RenminHospital,WuhanUniversity,Wuhan430060,China 【Abstract】ObjectiveTo explore the diagnosis and treatment of epidural and subdural abscess after craniotomy. Methods The clinical data of 18 patients with epidural and subdural abscess after craniotomy treated by debridement and continuous closed irrigation and drainage (CCID) were analyzed retrospectively. CCID lasted from 6 to 10 days after the debridement. Results Of 18 patients with abscess, 17 were cured after extubation and 1 who had intracerebral abscess after the epidural and subdural abscess was cured by the subsequent puncture and drainage of the intracerebral abscess. The following up from 3 to 12 months showed that there was no recurrence of intracranial infection in all the patients. Conclusions The results of head CT and (or) MRI examination can provide important basis for the diagnosis of the epidural and subdural abscess after the craniotomy. The curative effect of debridement and CCID on epidural and subdural abscess after cranio