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1983～1988年间收治23例脑脓肿,除2例入院时昏迷行紧急穿刺于24小时内死亡外,21例按下述方式治疗均存活:原则上行脓肿穿刺,19例凭手及2例行立体定位穿刺。52%病人第一周内2次连续CT 扫描脓肿体积未变需重复穿刺,脓液培养全都发现一或数种病原菌。开初抗菌疗法用广谱抗菌素,给一种第三代头孢菌素,联合一种氨基醣甙类及一种抗厌氧菌剂。病原菌分离后则给适合的抗菌治疗。尽早摘除原发感染灶。CT 增强扫描按表现不同分为4类:脓肿伴肿块效应(M~+),环形影无肿块效应(M~-),反映愈合过程中炎性阶段的结节影(N),后遗性低密度影(H)。全部随访6个月或更长。结果:21例无一死亡,治疗期限与CT 表现相适
Twenty-three cases of brain abscess were admitted between 1983 and 1988. Except for 2 cases who died of unconscious emergency puncture on admission, they all survived within 24 hours. 21 cases were survived according to the following methods: Positioning puncture. 52% of patients in the first week of 2 consecutive CT scans abscess volume unchanged need repeated puncture, pus culture all found one or several kinds of pathogens. Early antibacterial therapy with broad-spectrum antibiotics, to a third-generation cephalosporins, combined with an aminoglycoside and an anti-anaerobic agents. After the isolation of pathogens to the appropriate antibacterial therapy. Remove the primary infection as soon as possible. According to the different manifestations, CT enhanced scanning was divided into four groups: abscess with mass effect (M ~ +), ring shadow without mass effect (M ~ -), reflecting the nodules (N) Low density shadow (H). All patients were followed up for 6 months or longer. Results: There was no death in 21 cases. The duration of treatment was consistent with CT findings