Papo I, Perria C, Carai M, Casu G, Recchioni M A, Rocca A, Sgaramella E
Neurosurgical Department, General Regional Hospital, Ancona.
Zentralbl Neurochir. 1989;50(1):34-8.
The indications and the results of different surgical procedures for the management of intracranial abscesses are dealt in a cooperative study. Two series, amounting 68 patients altogether, collected in epidemiologically homogeneous areas with high percentage of rural population without adequate medical control, are appraised. Due to the high rate of chronic lesions, particularly in the pre-CT scan era (1968-1975), radical excision was required in 70.6% of cases. Overall postoperative mortality was 14.7%: 7.3% during the hospital stay, mostly due to pyrogenic ventriculitis in patients with large deep located abscesses, and 7.4% for different complications, both intra- and extracerebral, at home or other institutions several months after surgery. 29% of patients recovered completely and 45.6% have only minor disability, only 10.3% remained severely crippled and dependent. The results of the surgery, both in terms of operative mortality and functional recovery seem to depend on the neuropathological background rather than on the kind of therapeutic procedure implemented. Even though it must be acknowledged that at present conservative and minor surgical procedures are more often successfully used, radical excision still appears to keep far from negligible indications.
一项合作研究探讨了治疗颅内脓肿的不同外科手术方法的适应症及效果。对两个系列共68例患者进行了评估，这些患者来自农村人口比例高且医疗管控不足的流行病学同质地区。由于慢性病变发生率高，尤其是在CT扫描前的时代（1968 - 1975年），70.6%的病例需要进行根治性切除。术后总体死亡率为14.7%：住院期间死亡率为7.3%，主要是由于深部大脓肿患者发生化脓性脑室炎；术后数月，因脑内和脑外不同并发症在家中或其他机构死亡的比例为7.4%。29%的患者完全康复，45.6%仅有轻微残疾，只有10.3%仍严重致残且依赖他人。手术结果，无论是手术死亡率还是功能恢复，似乎都取决于神经病理背景，而非所实施的治疗方法类型。尽管必须承认，目前保守和小型外科手术更常成功应用，但根治性切除的适应症似乎仍不可忽视。
