神经内镜灌洗治疗脑室炎：病例报告及文献综述

Neuroendoscopic lavage for ventriculitis: Case report and literature review.

作者信息

Qin G, Liang Y, Xu K, Xu P, Ye J, Tang X, Lan S

机构信息

Department of Neurosurgery, People's Hospital of Guangxi Zhuang Autonomous Region, 06 Taoyuan Road, 530021 Nanning, China.

出版信息

Neurochirurgie. 2020 Apr;66(2):127-132. doi: 10.1016/j.neuchi.2019.12.005. Epub 2020 Feb 19.

DOI:10.1016/j.neuchi.2019.12.005

PMID:32087178

Abstract

BACKGROUND

Ventriculitis, one of the difficulties in neurosurgical treatment, is a significant cause of death and morbidity in patients with hydrocephalus. Neuroendoscopy is widely used in the treatment of non-communicable hydrocephalus. The advantages of neuroendoscopy may play a decisive role in the treatment of ventriculitis.

CASE REPORT AND METHODS

We report a 34-year-old male patient with refractory fever and rapid progressive disturbance of consciousness due to ventriculitis caused by intraventricle rupture in a left colliculus abscess. He received intravenous (IV) antibiotics and saline neuroendoscopic lavage (NEL) combined with septostomy and endoscopic third ventriculostomy leading to rapid recovery and remission of symptoms. We also reviewed the use of NEL for ventriculitis in PubMed from 1970 to January 20, 2019.

RESULTS

In our review, 93 cases (including the present report) were treated with NEL; 91 cases of infection subsided, and 7 patients died.

CONCLUSION

NEL may be an effective method for the treatment of ventriculitis.

摘要

背景

脑室炎是神经外科治疗中的难题之一，是脑积水患者死亡和发病的重要原因。神经内镜广泛应用于非交通性脑积水的治疗。神经内镜的优势可能在脑室炎的治疗中起决定性作用。

病例报告与方法

我们报告一名34岁男性患者，因左侧丘脑出血破入脑室导致脑室炎，出现难治性发热和意识快速进行性障碍。他接受了静脉抗生素治疗以及生理盐水神经内镜灌洗（NEL），并联合隔造口术和内镜下第三脑室造瘘术，症状迅速缓解。我们还回顾了1970年至2019年1月20日在PubMed上关于NEL治疗脑室炎的使用情况。