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颅内脑脓肿的病因和人口统计学特征研究:来自巴基斯坦的连续病例系列研究。

The study of etiologic and demographic characteristics of intracranial brain abscess: a consecutive case series study from Pakistan.

机构信息

Dow University of Health Sciences, Karachi, Pakistan.

出版信息

World Neurosurg. 2011 Jul-Aug;76(1-2):195-200; discussion 79-83. doi: 10.1016/j.wneu.2011.02.011.

Abstract

BACKGROUND

To determine the demographics, management, bacteriological spectrum, and outcome of brain abscesses of patients brought to Aga Khan University Hospital (AKUH), Karachi, with a history of neurologic symptoms and to examine the factors associated with it.

METHODS

This hospital-based descriptive study included 53 patients from both sexes who presented to the neurosurgery section at AKUH from January 1, 2000, until December 31, 2008, with neurologic symptomatology and fulfilling other inclusion criteria. Data regarding their demographic profile and other factors were collected in a well-structured proforma. Data were analyzed using frequencies, proportions, group means, and standard deviations.

RESULTS

The male-to-female ratio in our study was 3.4:1, with Staphylococcus milleri (20.7%) being the most common etiologic agent followed by anaerobic bacteria (15.1%). The triad of headache, fever, and vomiting was present in 62.7% of patients at the time of presentation. The most important factors influencing mortality was the neurologic condition of the patient at the time of admission. Chronic suppurative otitis media was the most common predisposing factor for temporal lobe infections, and the frontal lobe was the most common site of involvement in majority of the patients (67.8%). The mortality rate in our study was 11.3%.

CONCLUSION

Findings suggest that patients in the second and fourth decades of life are the most susceptible, both in terms of morbidity and mortality. Early diagnosis and appropriate management, along with rapid access to tertiary care centers, will lead to a better prognosis.

摘要

背景

为了确定在卡拉奇 Aga Khan 大学医院(AKUH)就诊的、有神经系统症状史的脑脓肿患者的人口统计学、治疗、细菌谱和结局,并研究与之相关的因素。

方法

这项基于医院的描述性研究纳入了 2000 年 1 月 1 日至 2008 年 12 月 31 日期间在 AKUH 神经外科就诊的 53 名有神经系统症状的男女患者,这些患者符合其他纳入标准。收集了他们的人口统计学资料和其他因素的相关数据,并记录在一份结构化的表格中。采用频率、比例、组均数和标准差对数据进行分析。

结果

本研究中男性与女性的比例为 3.4:1,最常见的病原体是米勒链球菌(20.7%),其次是厌氧菌(15.1%)。就诊时,62.7%的患者有头痛、发热和呕吐三联征。影响死亡率的最重要因素是患者入院时的神经状况。慢性化脓性中耳炎是导致颞叶感染的最常见易感因素,而额叶是大多数患者(67.8%)最常见的受累部位。本研究的死亡率为 11.3%。

结论

研究结果表明,在发病率和死亡率方面,第二和第四个十年的患者最易患病。早期诊断和适当的治疗,以及迅速获得三级保健中心的服务,将带来更好的预后。

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