本文選題：后顱窩腫瘤 + 顱內(nèi)感染�。� 參考：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的探討后顱窩腫瘤術(shù)后僅合并顱內(nèi)感染的早期臨床特點(diǎn)及抗菌藥物治療效果。方法回顧性分析重慶醫(yī)科大學(xué)附屬第一醫(yī)院神經(jīng)外科2014年3月至2016年3月顯微神經(jīng)外科手術(shù)治療的后顱窩腫瘤患者195例,依據(jù)術(shù)后僅合并顱內(nèi)感染的納入排除標(biāo)準(zhǔn),分析早期顱內(nèi)感染的臨床特點(diǎn)、腦脊液(cerebrospinal fluid,CSF)檢查結(jié)果。依據(jù)不同時(shí)期經(jīng)驗(yàn)性抗感染治療藥物分成碳青霉烯類組和聯(lián)合用藥組(碳青霉烯類+萬古霉素),比較兩組治療效果。結(jié)果共計(jì)納入26例,術(shù)后平均發(fā)熱時(shí)間為(6.2±3.7)d,經(jīng)驗(yàn)性抗感染治療時(shí)間為(7.1±3.4)d,首次腰椎穿刺時(shí)間為(7.9±3.5)d,CSF有核細(xì)胞數(shù)高峰期為(10.2±3.3)d,首次和高峰期有核細(xì)胞數(shù)分別為(665.4±324.6)×106/L、(1935.1±1437.3)×106/L,后者較首次明顯升高(P0.05)。CSF培養(yǎng)陽性5例,以Gˉ菌為主,單用碳青霉烯類組治療時(shí)間(16.6±7.7)d,聯(lián)合用藥組治療時(shí)間(15.5±4.8)d,兩組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論后顱窩腫瘤術(shù)后顱內(nèi)感染早期臨床特點(diǎn)無特異性,且CSF培養(yǎng)陽性率低,術(shù)后疑似顱內(nèi)感染,需多次CSF檢查,盡早經(jīng)驗(yàn)性使用抗Gˉ菌藥物。
[Abstract]:Objective to investigate the early clinical features of intracranial infection after operation of posterior cranial fossa tumor and the therapeutic effect of antimicrobial agents. Methods 195 patients with posterior cranial fossa tumor treated by microneurosurgery from March 2014 to March 2016 in the first affiliated Hospital of Chongqing Medical University were retrospectively analyzed. To analyze the clinical features of early intracranial infection and the results of cerebrospinal fluid cerebrospinal fluid (CSF) examination. According to the experience of different period of anti-infective treatment drugs were divided into carbapenem group and combination group (carbapenem vancomycin group) and compared the therapeutic effects between the two groups. Results A total of 26 cases were included, The average postoperative fever time was 6.2 鹵3.7 days, the time of empirical anti-infective therapy was 7.1 鹵3.4 days, the first lumbar puncture time was 7.9 鹵3.5 d, the peak number of nucleated cells in CSF was 10.2 鹵3.3 d, and the number of nucleated cells in the first and peak periods were 665.4 鹵324.6 脳 10 6 / L, 1935.1 鹵1437.3) 脳 10 6 L, respectively. The treatment time was 16.6 鹵7.7 days in the carbapenem group and 15.5 鹵4.8 days in the combined treatment group. There was no significant difference between the two groups (P 0.05). Conclusion the early clinical features of intracranial infection after operation of posterior cranial fossa tumor are not specific, and the positive rate of CSF culture is low. The suspected intracranial infection after operation should be examined by CSF many times, and the anti-G bacteria drug should be used empirically as soon as possible.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R739.4

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