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目的 :探讨脑脓肿的诊断和治疗的最佳方法。方法 :对 1 91例脑脓肿病例的临床表现、诊断、治疗进行分析。结果 :发热、头痛、呕吐为脑脓肿的主要临床表现 ,意识障碍、癫痫发作、视乳头水肿、颈项强直次之 ;1 91例中 71例行头颅 CT检查均符合脑脓肿的 CT表现 ;隐源性脑脓肿 59例 ( 3 0 .9% )仅次于耳源性脑脓肿 ;1 91例中 ,手术切除 1 2 7例 ,死亡 3 6例。穿刺抽脓 1 2例 ,死亡 1例。置管引流 9例 ,死亡 7例。 1 6例行单纯抗生素治疗治愈。入院时因急重死亡 ,以及放弃治疗共 2 7例。结论 :全身中毒症状、颅内压增高以及神经系症状是脑脓肿的主要临床表现。CT是诊断脑脓肿的最佳方法。隐源性脑脓肿在临床所占比例有增加趋势。除外科手术治疗外 3 cm以下脑脓肿在 CT监护下的广谱、足量、联合应用抗生素治疗亦能取得良好效果
Objective: To explore the best method of diagnosis and treatment of brain abscess. Methods: The clinical manifestations, diagnosis and treatment of 191 cases of brain abscess were analyzed. Results: Fever, headache and vomiting were the main clinical manifestations of brain abscess, disturbance of consciousness, seizures, papilledema and neck stiffness. Among the 91 cases, brain CT examination of 71 cases was consistent with CT findings of cerebral abscess; Fifty-nine cases of brain abscess (30.9%) were second only to otoacanthic abscess. Among 119 cases, 127 cases were surgically removed and 36 cases died. Puncture pus in 12 cases, 1 died. 9 cases of catheter drainage, death in 7 cases. 16 routine antibiotic treatment cured. Severe death on admission, and give up a total of 27 cases of treatment. Conclusion: The symptoms of systemic poisoning, increased intracranial pressure and neurological symptoms are the main clinical manifestations of brain abscess. CT is the best way to diagnose brain abscess. Cryptic brain abscess in the clinical proportion has an increasing trend. In addition to surgical treatment of brain abscess less than 3 cm in the broad spectrum of CT monitoring, adequate, combined with antibiotic treatment can achieve good results