[1]杨琴,李梅.硬膜下穿刺术在小儿化脓性脑膜炎后硬膜下积液诊治中的作用[J].陆军军医大学学报(原第三军医大学学报),2009,31(07):623-625.
 YANG Qing,LI Mei.Subdural puncture in diagnosis and treatment of subdural fluid collection in infants or toddlers with purulent meningitis: report of 207 cases[J].J Amry Med Univ (J Third Mil Med Univ),2009,31(07):623-625.
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硬膜下穿刺术在小儿化脓性脑膜炎后硬膜下积液诊治中的作用(/HTML )
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陆军军医大学学报(原第三军医大学学报)[ISSN:1000-5404/CN:51-1095/R]

卷:
31卷
期数:
2009年第07期
页码:
623-625
栏目:
论著
出版日期:
2009-04-15

文章信息/Info

Title:
Subdural puncture in diagnosis and treatment of subdural fluid collection in infants or toddlers with   purulent meningitis: report of 207 cases
作者:
杨琴李梅
重庆医科大学附属儿童医院神经内科
Author(s):
YANG Qing LI Mei
Department of Neurology, Children’s Hospital, Chongqing Medical University, Chongqing 400014, China
关键词:
小儿硬膜下穿刺术化脓性脑膜炎硬膜下积液
Keywords:
infant subdural puncture subdural fluid collection bacterial meningitis
分类号:
R617;R725.123
文献标志码:
A
摘要:
目的    探讨硬膜下穿刺术在小儿化脓性脑膜炎并发硬膜下积液的诊断及治疗中的作用。    方法    分析总结2005年1月1日至2008年7月30日我院收治的207例小儿化脓性脑膜炎病例,对硬膜下穿刺术,头颅B超、CT及MRI在明确有无化脓性脑膜炎后硬膜下积液的诊断中所起的作用进行评价,同时对硬膜下穿刺术及引流术在治疗化脓性脑膜炎后硬膜下积液中作用进行分析。    结果    207例化脓性脑膜炎中,42例合并硬膜下积液。头颅B超发现硬膜下积液者14例(33%),头颅CT发现者25例(60%),头颅MRI发现者4例(10%)。经头部影像学(B超、CT、MRI)发现阳性者共为33例(79%),而影像学检查未发现、经硬膜下穿刺术确诊的有9例(21%)。42例均行硬膜下穿刺术,33例内科好转治愈,仅7例转外科行引流术, 其中6例治愈。    结论    硬膜下穿刺术在小儿化脓性脑膜炎诊治中具有不可替代的作用。
Abstract:
Objective    To investigate the role of subdural puncture (SDP) in the diagnosis and treatment of subdural fluid collection in young children with purulent meningitis.     Methods    Totally 207 <2-year-old children with diagnosed purulent meningitis were collected and reviewed. Their incidence of subdural fluid collection were evaluated with SDP, ultrasonography, computerized tomography (CT) scanning or magnetic resonance imaging (MRI). The identified collection was released subsequently or treated by placing a subdural drain whenever the collection was either clinically eloquent or exerted a mass effect on the brain.     Results    There were 42 patients found subdural fluid collection in the 207 children. Among them, 33 cases (79%) were confirmed with imaging techniques (14, 25 or 4 children by ultrasonography, CT or MRI), but the other 9 cases (21%) were not found by them but only by SDP. The final diagnosis of these subdural fluid collection patients was made based on SDP. No any other surgery other than SDP was performed in 33 patients who were recovery later because the fluid collection was small or did not recur after SDP. Among the 7 patients requiring placement of a subdural drain, one infant underwent craniectomy and membrane resection, and 6 patients were recovered except one abandoned treatment because of family economy.     Conclusion    SDP plays an important role in the diagnosis and treatment of subdural fluid collection in young children after purulent meningitis.

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更新日期/Last Update: 2009-04-15