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目的 探讨成人脑室-腹腔分流术后晚期感染并发症的临床特点及治疗措施.方法 回顾性分析北京协和医院神经外科收治的4例脑积水术后感染患者的临床资料.对术后出现腹腔源性感染及多发感染并发症进行分析,并复习相关文献,总结其临床特点.结果 4例术后晚期感染者均为交通性脑积水行脑室-腹腔分流术后患者.其中2例患者表现为粘连性肠梗阻、1例患者为多发腹腔内脓肿,1例患者为肺部及泌尿系感染,均合并颅内感染.经拔除脑室-腹腔分流管、抗生素治疗后感染均得到控制,后期行二次分流手术,疗效满意出院.随访6个月以上,4例患者均无感染复发.结论 脑室-腹腔分流术后晚期感染,尤其腹腔源性感染临床相对少见,并常合并颅内感染.其治疗过程复杂,持续引流及系统性抗生素治疗是关键.“,”Objective To explore clinical characteristics , prevention and treatment of advanced infection as a complication of ventriculoperitoneal ( VP) shunt.Methods The clinical data of 4 patients with hydrocephalus underwent VP shunt admitted in Peking Union Medical College Hospital were analyzed retrospectively .Results 3 cases of abdominal infection and 1 of multisystemic infection were presented , all of which were patients developing hydrocephalus after neurosurgery.2 of them were cases of adhesive intestinal obstruction and intracranial infection , 1 case was multiple abdominal abscesses , while the other one was a case of intracranial infection combined with urinary tract infection and pulmonary infection.These 4 patients were treated effectively by shunt removal and intravenous administration of antibiotics and there was no relapse during the 6-month follow-up.Conclusions VP-shunt related advanced infection has non-specific clinical manifestations and is often associated with intracranial infection. Staphylococcus is one of the major pathogens.Shunt removal or externalization and systematic antibiotics treatment is usually required.