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低级别医疗机构中先天性心脏病患儿脑脓肿的钻孔抽吸术:病例系列

Brain abscess burr hole aspiration in children with congenital heart disease in low facility centers: case series.

作者信息

Abdulghani Yasser Seddeg, Elzain Mohammed Awad, Ahmed Abubakr Darrag Salim, Abdelhalim Salaheldin Awad

机构信息

Department of Anatomy, National Ribat University, Khartoum, Sudan.

Department of Neurosurgery, King Abdullah Hospital, Bisha, Saudi Arabia.

出版信息

Sudan J Paediatr. 2021;21(1):61-66. doi: 10.24911/SJP.106-1589487269.

Abstract

This is a prospective cross-sectional study on brain abscess burr hole aspiration in children with congenital heart disease (CHD) performed from January 2018 to March 2019. All patients were operated on through a burr hole, and then received intravenous antibiotics for 6 weeks and orally for 2 weeks either empirically or according to the results of abscess culture, if positive. The follow-up of cranial computed tomography or brain magnetic resonance image with contrast was obtained after 2 months (post-operatively) to assess the effectiveness of the procedure and to look for any residual or recurrent abscesses. Data were collected in a designed data collection sheet and analysed using -20. Thirteen patients were found to satisfy inclusion criteria. The most common presenting symptoms were fever ( = 11/13, 84.6%), vomiting ( = 7/13, 53.8%), headache ( = 6/13, 46.2%), convulsions ( = 6/13, 46.2%), focal weakness ( = 3/13, 23.1%), and impaired level of consciousness ( = 1/13, 7.7%). No bacterial growth was detected in two-thirds of the cases (69.2%), while the culture was positive in the remaining one-third (30.8%). The follow-up images showed complete resolution of the abscesses except in one case ( = 1/13, 7.7%), which required a second session of aspiration. One patient died ( = 1/13, 7.7%) on the 19th post-operative day due to severe pneumonia. Aspiration of brain abscess in children with CHD through a burr hole is a safe and effective procedure in terms of operative time, duration of anaesthesia and postoperative complications.

摘要

这是一项前瞻性横断面研究,于2018年1月至2019年3月对患有先天性心脏病(CHD)的儿童进行脑脓肿钻孔抽吸术。所有患者均通过钻孔进行手术,然后根据脓肿培养结果(若为阳性)经验性地或根据培养结果接受6周静脉抗生素治疗和2周口服抗生素治疗。术后2个月进行头颅计算机断层扫描或增强脑磁共振成像随访,以评估手术效果并查找任何残留或复发性脓肿。数据收集在设计好的数据收集表中,并使用-20进行分析。发现13名患者符合纳入标准。最常见的症状是发热(11/13,84.6%)、呕吐(7/13,53.8%)、头痛(6/13,46.2%)、惊厥(6/13,46.2%)、局灶性无力(3/13,23.1%)和意识水平受损(1/13,7.7%)。三分之二的病例(69.2%)未检测到细菌生长,而其余三分之一(30.8%)培养结果为阳性。随访影像显示除1例(1/13,7.7%)外脓肿完全消退,该例需要再次抽吸。1例患者(1/13,7.7%)在术后第19天因严重肺炎死亡。对于患有CHD的儿童,通过钻孔进行脑脓肿抽吸术在手术时间、麻醉持续时间和术后并发症方面是一种安全有效的手术。

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