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奥马亚贮液器感染率:一项针对儿科奥马亚贮液器的6年回顾性队列研究。

Ommaya reservoir infection rate: a 6-year retrospective cohort study of Ommaya reservoir in pediatrics.

作者信息

Bin Nafisah Sharafaldeen, Ahmad Maqsood

机构信息

National Neurosciences Institute, King Fahad Medical City, PO Box 395529, Riyadh, 11375, Saudi Arabia,

出版信息

Childs Nerv Syst. 2015 Jan;31(1):29-36. doi: 10.1007/s00381-014-2561-x. Epub 2014 Oct 10.

Abstract

OBJECTIVES

In this study, we investigated Ommaya reservoir among pediatric patients, its infection rate, and the predisposing factors. We also investigated its role in the reduction of CSF protein. Finally, we explored other factors that would influence the decision to insert an Ommaya in comparison to external ventricular drainage.

METHODS

This is a 6-year retrospective cohort study from a tertiary hospital in Saudi Arabia.

RESULTS

In our study, females were 48.9% (n = 22) while males were 51.1% (n = 23). The mean age at insertion was 2.9 days, SD of 1.67 day. The mean weight at insertion was 0.98 kg, SD of 0.57 kg. The total duration of Ommaya days was 2523 days. The median duration of the reservoir was 21 days. The Ommaya reservoir infection rate was 6.6%. We found an association between organisms cultured from urinary tract and the organisms cultured from the CSF. We also found that CSF protein level is lower in non-infected reservoirs in comparison to those with infection. The number of Ommaya days and the number of days of infection could not explain the mean CSF protein.

CONCLUSIONS

Ommaya reservoir has a low infection rate. Although CSF protein increased by infection, we failed to prove that Ommaya tapping provides a reduction in the CSF protein and, hence, reduction of shunt malfunctions thereafter. We conclude with expert opinions that take into account the psychological factors in addition to the clinical sense in choosing between Ommaya reservoir and external ventricular drainage (EVD).

摘要

目的

在本研究中,我们调查了儿科患者中的奥马亚贮液器、其感染率及易感因素。我们还研究了其在降低脑脊液蛋白方面的作用。最后,我们探讨了与外部脑室引流相比,其他会影响决定植入奥马亚贮液器的因素。

方法

这是一项来自沙特阿拉伯一家三级医院的6年回顾性队列研究。

结果

在我们的研究中,女性占48.9%(n = 22),男性占51.1%(n = 23)。植入时的平均年龄为2.9天,标准差为1.67天。植入时的平均体重为0.98千克,标准差为0.57千克。奥马亚贮液器使用的总天数为2523天。贮液器的中位使用时间为21天。奥马亚贮液器感染率为6.6%。我们发现从尿路培养出的微生物与从脑脊液中培养出的微生物之间存在关联。我们还发现,与感染的贮液器相比,未感染的贮液器中脑脊液蛋白水平较低。奥马亚贮液器使用天数和感染天数无法解释脑脊液蛋白的均值。

结论

奥马亚贮液器感染率较低。尽管感染会使脑脊液蛋白升高,但我们未能证明抽取奥马亚贮液器中的脑脊液能降低脑脊液蛋白,从而减少随后的分流故障。我们结合专家意见得出结论,在选择奥马亚贮液器和外部脑室引流(EVD)时,除临床判断外,还应考虑心理因素。

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