Longatti P, Perin A, Ettorre F, Fiorindi A, Baratto V
Neurosurgical Unit, Treviso Hospital, Padova University, Treviso, Italy.
Childs Nerv Syst. 2006 Nov;22(11):1447-50. doi: 10.1007/s00381-006-0119-2. Epub 2006 May 30.
Stereotactic aspiration with external drainage has become widely accepted as the standard treatment for intracerebral abscesses. Although neuroendoscopic technique has only been occasionally adopted for this pathology, it introduces some advantages because it presents visual awareness that the pus has been removed.
Four patients with cerebral abscess and one with a subdural empyema were operated using a neuroendoscopic technique in our Department between 1996 and 2003. A 4-mm flexible endoscope was introduced into the purulent collection through a burr hole, the pus was meticulously aspirated, and the cavity washed with isovolumetric antibiotic lavages using the working channel for both irrigation and suction.
Neuroendoscopic treatment of brain abscesses presents some additional advantages as a possible alternative to stereotactic aspiration, which still constitutes the gold standard for this pathology. The adoption of stereotactic or frameless guidance systems can probably be recommended particularly for deep, complex lesions.
立体定向穿刺外引流术已被广泛接受为脑脓肿的标准治疗方法。尽管神经内镜技术仅偶尔用于这种病症，但它具有一些优势，因为它能直观确认脓液已被清除。
1996年至2003年间，我科对4例脑脓肿患者和1例硬膜下积脓患者采用神经内镜技术进行手术。通过钻孔将一根4毫米的软性内镜插入脓性病灶，仔细抽吸脓液，然后利用工作通道进行等量抗生素灌洗，同时进行冲洗和抽吸以清洗脓腔。
作为立体定向穿刺的一种可能替代方法，神经内镜治疗脑脓肿具有一些额外优势，而立体定向穿刺仍是这种病症的金标准。对于深部、复杂病变，可能尤其推荐采用立体定向或无框架引导系统。
