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细菌性脑脓肿的治疗及预后

Author
Frederick S Southwick, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Anna R Thorner, MD
Translators
周立春, 主任医师，副教授

引言

脑脓肿为脑实质内的局灶性病变，可作为多种感染、创伤或手术的并发症而发生。脑脓肿的临床表现较为隐匿，故成功的治疗有赖于对该感染保持高度怀疑，并常常需要联合引流和抗菌治疗。表中总结了治疗的关键步骤(表 1)。

细菌性脑脓肿的治疗及预后见此专题，该病的发病机制、临床表现和诊断将单独讨论。 (参见“脑脓肿的发病机制、临床表现和诊断”)

治疗

成功治疗脑脓肿通常需抗生素联合外科引流(既有诊断价值又有治疗作用)[1-4]。

抗生素 — 根据脓肿的可能来源和可能涉及的病原体，有多种药物可供选择，这些抗生素包括：

●青霉素G可覆盖大部分口腔菌群，包括需氧和厌氧链球菌。然而，产青霉素酶厌氧菌[例如，脆弱拟杆菌(Bacteroides fragilis)、普雷沃菌属(Prevotella)某些种及其他细菌]的出现是青霉素疗法的一个潜在限制因素。

          

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Literature review current through: 2017-07 . | This topic last updated: 2015-12-23.
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