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目的探索立体定向穿刺置管冲洗引流术治疗脑脓肿的临床效果。方法选择2008年1月—2012年1月治疗的19例脑脓肿患者作为研究对象,采用高精度脑立体定向仪系统ASA-602S进行穿刺引流术,步骤包括头部框架的安装、CT扫描定位并读取坐标值、穿刺置管冲洗引流,术后每日冲洗脓腔1-2次。术后72 h复查CT,如脓腔消失则拔去引流管,拔管后继续给予抗感染、脱水、补液等对症治疗;如脓腔继续存在,则延迟拔管。结果本组19例患者均准确穿刺,CT或MRI复查显示脑脓肿均完全消失,治愈率100%。未遗留神经功能障碍,无死亡病例,随访1年无复发。结论脑脓肿立体定向穿刺置管冲洗引流术定位准确,创伤小,疗效好,可作为治疗脑脓肿的首选方法,值得在临床推广应用。
Objective To explore the clinical effect of stereotactic puncture and catheter irrigation and drainage in the treatment of brain abscess. Methods Nineteen patients with brain abscess treated from January 2008 to January 2012 were enrolled in this study. Percutaneous drainage was performed with the high-precision stereotaxic system ASA-602S. The procedure included the installation of the head frame and the CT scanning Read the coordinates, puncture catheter irrigation drainage, abscess rinse 1-2 times a day after surgery. 72 h after surgery to review CT, such as disappearance of the abscess is pulled out drainage tube, extubation continue to give anti-infection, dehydration, rehydration and other symptomatic treatment; such as abscess continue to exist, then delay extubation. Results The group of 19 patients were accurately puncture, CT or MRI showed brain abscess disappeared completely, the cure rate was 100%. No left neurological dysfunction, no deaths, followed up for 1 year without recurrence. Conclusion Stereotactic and stereotactic drainage of brain abscess with drainage and drainage is accurate, less traumatic and has good curative effect. It can be used as the first choice for the treatment of brain abscess and is worthy of clinical application.