脑脓肿管理的长期见解:来自印度单一中心的8年研究。

Surgical neurology international Pub Date : 2025-07-18 eCollection Date: 2025-01-01 DOI:10.25259/SNI_100_2025
Anurag Srivastava, Anmol S Randhawa, Manoj Agarwal, Swarjith Nimmakayala, Viraj D Narola, Sameer Narad, Sandharbh Gautam, Jitendra Singh Verma, Pankaj Gupta, Rohin Bhatia, Yogesh Agarwal, Bhawani Shankar Sharma, Atibhi Goel
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引用次数: 0

摘要

背景:工业化国家和发展中国家在诊断和治疗脑脓肿方面仍然面临困难。其病因和治疗仍然复杂和不确定,这使得治疗和结果具有挑战性。方法:为了确定脑脓肿患者的治疗、人口统计学和影响结果的因素,我们对2015年1月至2023年12月期间在斋浦尔圣雄甘地医院接受脑脓肿手术治疗的48例患者的数据进行了回顾性分析,这些患者采用了图像引导抽吸、开颅和切除术。入院时年龄、性别、临床表现、部位、病变数量、易感因素、病因、感染机制、治疗方法、格拉斯哥昏迷评分(GCS)等变量进行独立分析。结果:40岁以上男性患者发生脑脓肿的风险较高。结果受入院GCS评分的影响。尽管感染原体培养成功率较低,但仅有16例(33.3%)培养阳性。这些病例中最常见的分离物是链球菌和结核性脓肿。虽然死亡率为10.4%,但89.5%的参与者有良好的结果。5例患者的预后较差,因为其中2例免疫抑制,1例1.8岁儿童患有脑室炎,另外2例GCS评分较低。结论:医学护理结合图像引导吸痰是治疗脑脓肿的有效方法,效果良好。很少需要切除和开颅手术。手术技术和手术与脑脓肿死亡率均无直接关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Long-term insights into brain abscess management: An 8-year study from a single center in India.

Long-term insights into brain abscess management: An 8-year study from a single center in India.

Long-term insights into brain abscess management: An 8-year study from a single center in India.

Long-term insights into brain abscess management: An 8-year study from a single center in India.

Background: Both industrialized and developing nations continue to face difficulties in diagnosing and treating brain abscesses. Their etiology and management are still complicated and uncertain, which make treatment and result challenging.

Methods: To ascertain management, demographics, and factors influencing the outcome of subjects with brain abscesses, we performed a retrospective analysis of data from 48 individuals who underwent surgical treatment for brain abscesses at Mahatma Gandhi Hospital in Jaipur between January 2015 and December 2023 using image-guided aspiration, craniotomy, and excision. Independent analyses were conducted on variables such as age, gender, clinical presentation, location, number of lesions, predisposing factors, etiological agent, infection mechanism, therapy, and Glasgow Coma Scale (GCS) score during admission.

Results: The risk of developing a brain abscess was higher for male patients over 40. The outcome was influenced by the admission GCS score. Only 16 instances (33.3%) had positive cultures, despite the low incidence of successful infectious agent culture. The most frequent isolates in these cases were Streptococcus sp. and tubercular abscess. While the death rate was 10.4%, 89.5% of the participants had favorable outcomes. Five patients had poor outcomes because of immunosuppression in two of them, a 1.8-year-old child had ventriculitis, and the other two had low GCS scores.

Conclusion: An efficient treatment for brain abscesses that have generally positive results is medical care combined with image-guided suction. excision and craniotomy are rarely necessary. Neither surgical technique nor surgery was directly associated with brain abscess mortality.

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