三叉神经痛微血管减压术后发热原因分析及防治的策略.docVIP

三叉神经痛微血管减压术后发热原因分析及防治的策略 　　【摘要】 目的：探讨三叉神经痛、面肌痉挛、舌咽神经痛患者术后发热原因，从而指导临床治疗。方法：收集本科近5年来实施三叉神经痛、面肌痉挛、舌咽神经痛的患者共841例，分为A组（常规应用抗菌药物组）、B组（临时应用抗菌药物组），对其发热比率、感染比率进行分析，并深入分析其发热原因，探讨其治疗策略。结果：两组患者发热率比较差异有统计学意义（P0.05）。结论：行微血管减压术后，过多的应用抗菌药物对预防颅内感染并无多大的意义；对于术后出现发热的患者，积极早期行腰椎穿刺脑脊液实验室检查必不可少；但由于颅内感染一旦确诊，将有可能造成非常严重的后果，因此，一旦高度怀疑颅内感染，建议早期积极应用抗菌药物进行干预。 　　【关键词】 微血管减压术； 发热； 颅内感染； 原因 　　The Analysis and Prevention Strategies that the Patients of Postoperative Fever that Microvascular Decompression of the Trigeminal Nerve/SUN Yan-chun，LI Ping，ZHAO Chang-di，et al.//Medical Innovation of China，2016，13（20）：135-139 　　【Abstract】 Objective：To investigate the reason of postoperative fever of the patients that was implemented of trigeminal neuralgia，hemifacial spasm and glossopharyngeal neuralgia，and to guide clinical treatment.Method：All of cases in our department nearly five years that the trigeminal neuralgia were collected，hemifacial spasm and glossopharyngeal neuralgia 841 patients.All of the cases were divided into two groups，group A（routine use of antibiotics），group B （temporary use of antimicrobial drugs group），the heat rate，infection rate were analyzed，and in-depth analysis of the causes of fever，explore treatment strategies.Result：Two groups had statistically significant difference in the heat rate（P0.05）.Conclusion：There is no obvious meaning that excessive use of antibiotics for the prevention of intra-cranial infection.This is essential for the patients with postoperative fever positive lumbar puncture and cerebrospinal fluid laboratory tests.We recommend that early and aggressive use of antibiotics to intervene if you highly suspected intra-cranial infection. 　　【Key words】 Microvascular decompression； Fever； Intracranial infection； Causes 　　First-author’s address：The First People’s Hospital of Ji’ning，Ji’ning 272000，China 　　doi：10.3969/j.issn.1674-4985.2016.20.037 　　原发性三叉神经痛、面肌痉挛、舌咽神经痛为常见病、多发病，由于其疼痛剧烈，故又被称为“天下第一痛”[1]，严重威胁着人类的身心健康。对于其治疗，多采用乙状窦后入路微血管减压术（MVD）[2]，多数患者可取得良好的手术效果；但术后部分患