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Clinical effect of the comprehensive treatment for postoperative intracranial infection based on the characteristics of pathogenic microorganisms |
YUAN Huaitao1,2 HUANG Liangwen2 REN Jianwei2 LIU Jianmin2 |
1.The First Clinical Medical School, Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510405, China;
2.Craniocerebral Department, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou 510405, China |
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Abstract Objective To summarize the experience of clinical diagnosis and treatment about the intracranial infection after craniocerebral operation, and to explore an effective method for the treatment of postoperative intracranial infection. Methods By retrospective analysis, 26 patients with intracranial infections after operation admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2007 to March 2015 were selected. All of the cases were treated with comprehensive treatment, such as cerebrospinal fluid cytology examination, bacterial culture, intravenous and intrathecal use of Ceftriaxone Sodium or other sensitive antibiotics. The conditions of cerebrospinal fluid bacterial culture, choice of antibacterial agents, choice of cerebrospinal fluid drainage and intrathecal administration, healing cases and healing time were observed. Results The results of cerebrospinal fluid bacterial culture in 14 cases were positive (53.8%), among which, there were 4 cases of Staphylococcus aureus, 4 cases of Staphylococcus epidermidis, 2 cases of Enterobacter aeruginosa, 2 cases of Escherichia coli and 2 cases of Pseudomonas aeruginosa. All of 12 cases of patients with negative cerebrospinal fluid bacterial culture results of Staphylococcus aureus and Epidermis staphylococcus, Enterobacter aeruginosa, Escherichia coli and cerebrospinal fluid culture were taken intravenous Ceftriaxone Sodium and intrathecal drug delivery. The effect of Ceftriaxone Sodium on patients whose cerebrospinal fluid bacterial culture result was Pseudomonas aeruginosa was poor. Therefore, 1 case was converted to Cefoperazone Sodium and Tazobactam, and 1 case was converted to Meropenem. Fifteen patients selected continued lumbar cistern drainagee, 11 cases selected lumbar puncture, cerebrospinal fluid replacement. Twenty-six patients were all cured, the difference of the healing time between lumbar puncture patients and lumbar cistern drainagee patients was not statistically significant (P > 0.05). Conclusion Based on the characteristics of pathogenic microorganisms, comprehensive therapy has a good effect on postoperative intracranial infection.
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