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[分流术治疗脑积水时感染性脑脊液的抗生素治疗]

[Antibiotic therapy of infected cerebrospinal fluid in hydrocephalus treated by a shunt].

作者信息

Isla Guerrero A, Peña García P, Ortega V, Alvarez Ruiz F, Moriche Carretero M, Paredes García E, García Blázquez M

机构信息

Servicio de Neurocirugía, Hospital La Paz, Madrid.

出版信息

An Esp Pediatr. 1988 Dec;29(6):435-9.

PMID:3072889
Abstract

Nine hydrocephalic shunted children with infected cerebrospinal fluid (CSF) were treated. Ages ranged from 0 to 10 years. Diagnosis was made through clinical symptoms, CSF examination, echographic and computed tomography (CT). The microorganism which was seen more frequently, was S. epidermidis. This germ was more often found in young children. Treatment of these patients consisted of a systematic change of the shunt which was externally diverted, implantation of a CSF Ommaya reservoir in the lateral ventricle, and intraventricular and systemic administration of antibiotic, were made. Using this protocol CSF sterilization was obtained in all cases, after 5 to 12 days of treatment. CSF shunt infected with S. epidermidis can be effectively cleaned with daily intra-shunt vancomycin, and shunt infected with gram-negative are also cleaned with daily intra-shunt gentamycin.

摘要

对9名患有感染性脑脊液(CSF)的脑积水分流儿童进行了治疗。年龄范围为0至10岁。通过临床症状、脑脊液检查、超声检查和计算机断层扫描(CT)进行诊断。最常发现的微生物是表皮葡萄球菌。这种病菌在幼儿中更常见。这些患者的治疗包括对外部分流的分流器进行系统性更换、在侧脑室植入脑脊液奥马亚储液器以及进行脑室内和全身抗生素给药。采用该方案,在治疗5至12天后,所有病例的脑脊液均实现了无菌化。表皮葡萄球菌感染的脑脊液分流可通过每日脑室内注射万古霉素有效清除,革兰氏阴性菌感染的分流也可通过每日脑室内注射庆大霉素清除。

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