Wang Jingsheng,Wang Chong,Liu Qibin,et al.Efficacy evaluations of surgery for suppurative meningitis with subdural effusion and ventriculitis in infants[J].Journal of Clinical Pediatric Surgery,,18():733-738.[doi:10.3969/j.issn.1671-6353.2019.09.005]
Efficacy evaluations of surgery for suppurative meningitis with subdural effusion and ventriculitis in infants
- Keywords:
- Purulent Meningitis; Subdural Effusion; Ventriculitis; Antibacterial Therapy; Surgical Procedures; Operative
- CLC:
- R726;R512.3
- Abstract:
- Objective To explore the efficacy and safety of surgical treatment of septic complication of infantile suppurative meningitis with subdural effusion,empyema and ventriculitis.Methods All enrolled subjects were divided into surgical and conservative treatment groups according to different treatment methods.Among them,the surgical group was composed of 33 hospitalized cases of suppurative meningitis with subdural effusion and ventriculitis from July 2009 to March 2018.There were subdural effusion (n=29) and ventriculitis (n=4).All cases were definitely diagnosed by lumbar puncture and cranial enhanced magnetic resonance (MR).In case of systemic use of sufficient sensitive antibiotics failing to effectively control infection,subdural effusion drainage,anterior iliac puncture,lateral cerebral drainage,craniotomy,external drainage and ventricular fenestration were employed.The conservative treatment group had 25 children of suppurative meningitis complicated with subdural effusion (n=23) and ventriculitis (n=2) from January 2005 to July 2009 at Shenzhen Children’s Hospital.Conservative treatment of internal medicine was offered.Statistical analysis was performed using SPSS 18.0.Results After the above treatments,28 cases were cured in surgical group with a cure rate of 84.8%,5 cases improved,none was ineffective and the median hospital stay was 27 days.In conservative treatment group,7 cases were cured with a cure rate of 28%,13 cases improved and 5 cases were ineffective.Among them,there were 3 deaths and the median hospital stay was 44 days.According to statistical tests,significant inter-group differences existed in cure rate and median hospital stay (P<0.05).Conclusion Subdural effusion and ventriculitis are refractory complications of infantile purulent meningitis.When simple medical treatment is ineffective,proper surgery may be selected for improving clinical efficacy,minimizing antibiotic use and lowering the incidence of long-term complications.
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Memo
收稿日期:2019-06-28。
通讯作者:陈乾,Email:chenqian68@126.com