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目的探讨先天性心脏病并发脑脓肿的诊断及治疗方法。方法回顾10年19例先天性心脏病并发脑脓肿患儿,分析其诊断、治疗特点及预后,并行文献资料分析。结果19例患儿,年龄3~16岁,平均7.4岁,男7例,女12例,病史3d~38个月,平均13个月。法洛四联症13例,肺动脉瓣狭窄合并房间隔缺损(或卵圆孔未闭)3例,室间隔缺损1例,室间隔缺损并肺动脉狭窄2例。16例CT及增强CT扫描确诊,3例MRI扫描确诊。CT动态扫描行疗效评估。抗生素保守治疗7例,治愈3例;外科手术治疗12例,治愈11例,手术方式为脓腔穿刺引流。随访时间9~48个月。结论先天性心脏病并发脑脓肿预后凶险,CT是诊断其最佳方法,早期穿刺引流是首选治疗手段。
Objective To investigate the diagnosis and treatment of congenital heart disease complicated with brain abscess. Methods Nineteen cases of congenital heart disease with brain abscess were retrospectively analyzed in 10 years. The diagnosis, treatment characteristics and prognosis were analyzed, and the literature data were analyzed. Results 19 cases of children aged 3 to 16 years old, with an average of 7.4 years old, 7 males and 12 females, history of 3d ~ 38 months, an average of 13 months. Tetralogy of Fallot in 13 cases, pulmonary valve stenosis with atrial septal defect (or patent foramen ovale) in 3 cases, ventricular septal defect in 1 case, ventricular septal defect and pulmonary stenosis in 2 cases. 16 cases of CT and enhanced CT scan confirmed, 3 cases of MRI scan confirmed. CT dynamic scan line evaluation. Seven cases of conservative treatment of antibiotics, cured in 3 cases; surgical treatment of 12 cases, 11 cases were cured, the surgical approach for abscess drainage. Follow-up time 9 to 48 months. Conclusions The prognosis of congenital heart disease complicated with brain abscess is dangerous. CT is the best method to diagnose it. Early puncture and drainage is the preferred treatment.