摩苏尔市影响脑脓肿预后和死亡率的因素

Ali H. Azeez, A. Al-Shalchy, O. Agha
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引用次数: 1

摘要

背景:脑脓肿是由多种细菌、真菌和寄生虫感染引起的脑内重要脓液聚集。它可以是单个或多个。病变的大小、位置和数量,以及生物体的致病性、宿主反应和脑水肿的严重程度,都影响表现。目的:评价脑脓肿的处理情况,并对患者的格拉斯哥预后评分(GOS)进行评价。患者和方法:研究于2014年1月至2021年1月在摩苏尔左海岸Ibn-Sina教学医院神经外科完成并进行。神经外科部门对70例脑脓肿患者进行了病例系列调查。年龄、性别、病程、初始神经外科状态和脓肿特征均在临床资料之列。比较格拉斯哥预后评分(GOS)良好、中度残疾或恢复良好的患者与GOS评分不佳、死亡或出院时持续植物人状态的患者。结果:男性48例,女性22例(男女比例2.2:1)。该系列包括52例预后良好的患者和18例预后不良的患者。这些患者的平均年龄为20岁。男性和女性对于有利和不利结果的差异是微不足道的。青紫型先天性心脏病的p值有显著性意义,因为脑脓肿的病因在儿童中尤为普遍(成人与儿童的比值为1:9)。单发脓肿最常见部位为额叶(25例),多数患者采用钻孔引流,效果最好。结论:脑脓肿的病死率虽然有了影像学技术的提高和抗生素的治疗,但仍较高,尤其是入院时意识水平较低的患者。
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Factors Influencing Outcome and Mortality of Brain Abscess in Mosul City
Background: Brain abscess by definition is a crucial pus collection inside the brain, resulted from the infection by a variety of bacteria, fungi, and parasite. It can be single or multiple. The size, position, and number of lesions, as well as the organism's pathogenicity, host reactions, and the severity of cerebral edema, all influence the presentation. Objective: To assess how well a brain abscess was managed and to evaluate the patients with favorable and unfavorable Glasgow outcome scale (GOS). Patients and methods: From January 2014 to January 2021, the study was achieved and conducted in the Neurosurgical Department of Ibn-Sina Teaching Hospital on Mosul's left coast. The neurosurgery unit managed a case series investigation of 70 patients who had a brain abscess. Age, sex, duration of illness, initial neurosurgical status, and abscess features are among the clinical data. A comparison was performed between patient with Favorable Glasgow outcome scale (GOS), moderate disability or those with good recovery and those with Unfavorable GOS, death or persist vegetate status outcome at discharge. Results: The study involved 48 male and 22 female patients (male / female ratios 2.2:1). The series consist of 52 patients who experienced favorable outcome and 18 resulted from an unfavorable outcome. The mean of age for those patients was 20 years. The difference between males and females regarding favorable and unfavorable outcomes is insignificant. P-value was significant in cyanotic congenital heart diseases as cause of brain abscess were particularly prevalent among the children (adult VS children = 1:9). The most common site for single abscesses was the frontal lobe (25 patients), and majority of patients treated with burr hole drainage, which had the best results. Conclusion: Although there were technological improvement of imaging and antibiotics treatment, the mortality of brain abscesses is still relatively high, especially among those with decreased level of consciousness on admission.
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