无功能脑室导管导致儿童脑脓肿1例报告

S. S. Gaibov, I. A. Zacharchyk, A. S. Serobyan, E. V. Zacharchyk, D. P. Vorobyev, R. Kim
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引用次数: 0

摘要

介绍。发生脑脓肿引起的脑室导管失效是一种罕见的并发症。这种方法可以被认为是一种预防感染并发症发生的措施。肺炎克雷伯菌作为脑脓肿发生的病因,据文献报道是比较少见的。介绍我们的经验,治疗儿童脑积水谁发展为脑脓肿引起的脑室导管失效。材料和方法。该研究的材料是一名4岁患者的临床病史,该患者因更换分流系统后留下的心室导管失效而导致脑脓肿。预防这种并发症的方法是在置换术中完全去除脑室-腹膜分流的成分。当形成脓肿时,最合适的方法是将其切开切除,同时使用无功能的导管,因为这样可以尽可能地消毒病理病灶。这种方法可以被认为是预防今后感染并发症发生的一种措施。如果出现脑脓肿合并导管、SPS不起作用,脑脊液中没有炎症改变的情况,建议将脑脓肿连同胶囊和导管一起切除,同时将腹膜导管从腹腔中取出。当完全切除脓肿囊是不可能的,或者脑脊液中已经有炎症变化,需要消毒时,这种策略也是合理的。对这种病理的微生物学方面的研究也引起了很大的临床兴趣。肺炎克雷伯菌在本例临床病例的微生物学研究中被分离出来,作为脑脓肿发生的病因,根据文献报道是罕见的。脑积水引流术后感染性并发症的发生及处理是神经外科亟待解决的问题。根据对文献的分析,可以说,关于这一主题的出版物的稀少性使得即使是个别报告也具有相关性,并且今天没有办法提出针对无功能心室导管的具体策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Non-functioning ventricular catheter as a cause of brain abscess in a child: case report
Introduction. The occurrence of a brain abscess caused by a non-functioning ventricular catheter is a rare complication. This approach can be considered a preventive measure for the occurrence of infectious complications. Klebsiella pneumoniae, as an etiological factor in the occurrence of brain abscess, is relatively rare according to literature.Aim. To present our experience of treating a child with hydrocephalus who developed a brain abscess caused by a nonfunctioning ventricular catheter.Materials and methods. The material for the study was the clinical history of a 4-year-old patient with a brain abscess caused by a non-functioning ventricular catheter left after the replacement of the shunt system.Results. The prevention of such a complication is the complete removal of the elements of the ventriculoperitoneal shunting during its replacement. When an abscess is formed, the most appropriate method is its open removal along with a non-functioning catheter, since this allows the pathological focus to be sanitized as much as possible. This approach can be considered a preventive measure for the occurrence of infectious complications in the future. If a condition occurs when there is a combination of a brain abscess against the background of a non-functioning catheter, SPS and there are no inflammatory changes in the cerebrospinal fluid, it is advisable to remove the brain abscess along with the capsule and catheter, as well as removing the peritoneal catheter from the abdominal cavity. This tactic is also justified when the total removal of the abscess capsule is impossible, or there are already inflammatory changes in the cerebrospinal fluid and it is necessary to sanitize it.Of great clinical interest is also the study of the microbiological aspects of this pathology. Klebsiella pneumoniae, which was isolated during a microbiological study in this clinical example, as an etiological factor in the occurrence of a brain abscess, is rare according to the literature.Conclusion. The problem of the occurrence and treatment of infectious complications after liquor-reshunting operations during hydrocephalus is an urgent task in neurosurgery. Based on the analysis of the literature, it can be said that the rarity of publications on this topic makes even individual reports relevant, and today there is no way to propose a specific strategy for a non-functioning ventricular catheter.
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