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目的 探讨儿童脑脓肿的临床诊断和治疗情况。方法 对 32例根据临床症状和辅助检查确诊为脑脓肿的患儿进行分析 ,观察内外科治疗效果。结果 32例儿童脑脓肿中具有典型三联征者仅 8例 (2 5 % ) ,全身感染表现者 14例 (43.8% ) ,头痛者 15例 (46 .9% ) ,神经系统定位体征者 14例 (43.8% ) ,癫痫样发作者 12例(37.5 % )。CT确诊者 2 8例 (87.5 % ) ,4例作MRI确诊。保守治疗 2 1例 ,脓肿消失 13例 ,缩小 6例 ,总有效率90 .5 %。外科治疗 13例 ,单纯穿刺抽脓术 8例 ,脓肿消失 5例 ,缩小 3例 ,脓肿切除术 5例 ,死亡 1例。结论 儿童脑脓肿临床症状多不典型 ,头颅CT扫描对确诊极具重要意义 ,保守治疗是本病的主要疗法 ,其次是单纯穿刺抽脓术。
Objective To investigate the clinical diagnosis and treatment of brain abscess in children. Methods 32 cases of children diagnosed as brain abscess based on clinical symptoms and auxiliary examination were analyzed to observe the effect of internal and surgical treatment. Results In 32 children with brain abscess, there were only 8 cases (25%) with typical triad symptoms, 14 cases (43.8%) with systemic infection, 15 cases (46.9%) with headache and 14 cases with neurological signs (43.8%), epilepsy in 12 cases (37.5%). 28 were diagnosed by CT (87.5%) and 4 were confirmed by MRI. Conservative treatment of 21 cases, abscess disappeared in 13 cases, reduced in 6 cases, the total efficiency of 90.5%. Surgical treatment of 13 cases, simple puncture and purulent surgery in 8 cases, abscess disappeared in 5 cases, reduced in 3 cases, abscess resection in 5 cases, 1 died. Conclusion The clinical manifestations of brain abscess in children are mostly atypical, and cranial CT scan is very important for the diagnosis. Conservative treatment is the main therapy of this disease, followed by simple puncture and pus.