Cai Yuxiang, Liu Jian, Jia Ge, Hou Yonghong, Wang Yanjin
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, P.R. China.
Department of Gamma-knife Therapy Center, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
BMC Infect Dis. 2025 Mar 18;25(1):373. doi: 10.1186/s12879-025-10770-4.
The aim of this study was to investigate the clinical presentation, imaging features, and outcome of patients diagnosed with brain abscess and treated by stereotactic aspiration.
We retrospectively analyzed the medical data of all consecutive patients diagnosed with brain abscess who underwent stereotactic aspiration in our department from 2015 to 2022. The demographic characteristics, clinical presentation, radiological data, microbial aetiology, and outcome were collected and analyzed using t-test or χ tests.
Overall, 120 patients were identified. The mean age was 49.7 years (range: 5-81); 59.2% were male. Seventy-nine patients (65.8%) had comorbidities, of which cardiovascular diseases was the most common. Most of the abscesses were solitary frontal or temporal lesions. A microbiological diagnosis was secured in 70 (58.3%) of cases, among which the majority were of the Streptococcus spp. Outcome was favorable in 107 (89.2%) of cases. The mortality rate during the initial hospital stay was 2.5%. A total of 10 individuals (8.3%) presented with preoperative delirium or coma, which was associated with an inferior clinical outcome compared to those who exhibited clear consciousness. (p = 0.01).
Stereotactic aspiration was a safe intervention with a low incidence of complications. The combination of stereotactic aspiration and antibiotic therapy was an effective treatment strategy for brain abscess. Patients who underwent stereotactic aspiration while in a state of disturbance of consciousness demonstrated a poorer outcome compared to those who were conscious.
Not applicable.
本研究旨在调查经立体定向穿刺抽吸治疗的脑脓肿患者的临床表现、影像学特征及预后。
我们回顾性分析了2015年至2022年在我科接受立体定向穿刺抽吸治疗的所有连续性脑脓肿患者的医疗数据。收集人口统计学特征、临床表现、放射学数据、微生物病因及预后情况，并采用t检验或χ检验进行分析。
共纳入120例患者。平均年龄49.7岁（范围：5 - 81岁）；男性占59.2%。79例（65.8%）有合并症，其中心血管疾病最为常见。大多数脓肿为额叶或颞叶单发病变。70例（58.3%）病例获得微生物学诊断，其中大多数为链球菌属。107例（89.2%）病例预后良好。初次住院期间死亡率为2.5%。共有10例（8.3%）患者术前出现谵妄或昏迷，与意识清醒的患者相比，其临床预后较差（p = 0.01）。
立体定向穿刺抽吸是一种安全的干预措施，并发症发生率低。立体定向穿刺抽吸与抗生素治疗相结合是治疗脑脓肿的有效策略。意识障碍状态下接受立体定向穿刺抽吸的患者与意识清醒的患者相比，预后较差。
不适用。
