Clinical characteristics and antimicrobial therapy of only intracranial infection in patients after posterior fossa tumor craniotomy: report of 26 cases

Fu'an Zhang; Dong Zhong; Shuang Shi; Jiong Li; Dong Lyu; Haoyang Huang; Haijian Xia; Wenyuan Tang; Xiaochuan Sun

doi:10.16016/j.1000-5404.201608114

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Clinical characteristics and antimicrobial therapy of only intracranial infection in patients after posterior fossa tumor craniotomy: report of 26 cases

Clinical Medicine | 更新时间：2020-08-05

- Clinical characteristics and antimicrobial therapy of only intracranial infection in patients after posterior fossa tumor craniotomy: report of 26 cases
- J Third Mil Med Univ Vol. 39, Issue 2, Pages: 192-195(2017)
- 作者机构：
  
  400016 重庆, 重庆医科大学附属第一医院神经外科
- 作者简介：
- 基金信息：
  
  Supported by the National Clinical Key-Discipline Construction Program of China(财社(2011)170号)
- DOI：10.16016/j.1000-5404.201608114
  CLC： R512.3;R619.3;R739.41
- Published：30 January 2017，
  
  Received：21 August 2016，
  
  Accepted：1 November 2016
扫描看全文
Fu'an Zhang, Dong Zhong, Shuang Shi, et al. Clinical characteristics and antimicrobial therapy of only intracranial infection in patients after posterior fossa tumor craniotomy: report of 26 cases. [J]. J Third Mil Med Univ 39(2):192-195(2017)
DOI：

Fu'an Zhang, Dong Zhong, Shuang Shi, et al. Clinical characteristics and antimicrobial therapy of only intracranial infection in patients after posterior fossa tumor craniotomy: report of 26 cases. [J]. J Third Mil Med Univ 39(2):192-195(2017) DOI： 10.16016/j.1000-5404.201608114.

摘要

目的

探讨后颅窝肿瘤术后仅合并颅内感染的早期临床特点及抗菌药物治疗效果。

方法

回顾性分析重庆医科大学附属第一医院神经外科2014年3月至2016年3月显微神经外科手术治疗的后颅窝肿瘤患者195例，依据术后仅合并颅内感染的纳入排除标准，分析早期颅内感染的临床特点、脑脊液(cerebrospinal fluid，CSF)检查结果。依据不同时期经验性抗感染治疗药物分成碳青霉烯类组和联合用药组(碳青霉烯类+万古霉素)，比较两组治疗效果。

结果

共计纳入26例，术后发热时间为(6.2±3.7)d，经验性抗感染治疗时间为(7.1±3.4)d，首次腰椎穿刺时间为(7.9±3.5)d，脑脊液有核细胞数高峰期为(10.2±3.3)d，首次和高峰期有核细胞数分别为(665.4±324.6)×10

/L、(1 935.1±1 437.3)×10

/L，后者较首次明显升高(

＜0.05)。CSF培养阳性5例，以G

菌为主

单用碳青霉烯类组治疗时间(16.6±7.7)d，联合用药组治疗时间(15.5±4.8)d，两组差异无统计学意义(

0.05)。

结论

后颅窝肿瘤术后颅内感染早期临床特点无特异性，且CSF培养阳性率低，术后疑似颅内感染需多次CSF检查，尽早经验性使用抗G

菌药物。

Abstract

Objective

To explore the clinical characteristics and antimicrobial therapy of only intracranial infection in patients after posterior fossa tumor craniotomy.

Methods

Clinical data of 195 patients with posterior fossa tumor

who accepted microneurosurgery in the department of neurosurgery of the First Affiliated Hospital of Chongqing Medical University from March 2014 to March 2016

were retrospectively analyzed. According to the inclusion and exclusion standards of intracranial infection

the research objects were selected

and the early clinical characteristics and the examination result of cerebrospinal fluid (CSF) were analyzed. According to different periods

empirical antibiotics were applied

and the patients were divided into 2 groups: carbapenem group and combination group (carbapenem+vancomycin). The treatment effects were compared.

Results

There were 26 cases in accordance with the inclusive criteria. The mean time of fever was 6.2±3.7 d

empirical antibiotic therapy was 7.1±3.4 d

the first time of lumber puncture was 7.9±3.5 d

and the time of the highest leukocyte count in CSF was 10.2±3.3 d. The first leukocyte count and the highest leukocyte count of CSF were (665.4±324.6)×10

/L and (1 935.1±1 437.3) ×10

respectively

and the latter was significantly higher than the former(

＜0.05). There were 5 cases of positive CSF culture

and Gram-negative bacteria were dominant. The treatment time of the carbapenem group was 16.6±7.7 d

while the combination group was 15.5±4.8 d

but the 2 groups had no significant difference (

0.05).

Conclusion

There is no significant clinical characteristics in early intracranial infection after posterior fossa tumor craniotomy

and has lower positive rate of CSF culture. If the patient is suspicious of intracranial infection

the clinician needs to carry out examination of CSF as soon as possible repeatedly. Meanwhile

any suspicious objects should be treated with empirical antibiotics against Gram-negative bacteria immediately.

关键词

后颅窝肿瘤颅内感染临床特点脑脊液抗菌药物治疗

Keywords

posterior fossa tumorintracranial infectionclinical characteristicscerebrospinal fluidantimicrobial therapy

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