Abstract：
Objective: Severe neurosurgical central nervous system infections (sNCNSIs) are among the most serious complications of neurosurgical disease. Conventional methods have shown a poor prognosis. This study aims to analyze the clinical characteristics of vacuum-assisted closure (VAC) in sNCNSIs with the help of antibiotic irrigation treatment. Patients and Methods: A retrospective study was performed for patients diagnosed with sNCNSIs. A VAC device was placed on the incision after debridement and the surgical cavity was rinsed with antibiotic agents in the VAC group. Meanwhile the surgical cavity was drained after debridement in the control group. Medical data were reviewed and analyzed. Results: Twenty-eight patients met the inclusion criteria, including 18 cases in the VAC group and 10 cases in the control group. The basic medical data showed no differences. Bacteria was isolated from 24 (85.7%) patients. The cure rate was significantly higher in the VAC group (p < 0.05). The cure rate in patients with multi-drug-resistant (MDR) infections was significantly higher in patients treated with VAC therapy (p < 0.05). The prognosis evaluated by Glasgow Outcome Score (GOS) between the two groups showed significant difference (p < 0.05). No re-infection in the VAC group occurred in the follow-up period. Conclusions: It is suggested that VAC-assisted antibiotic irrigation is safe and effective for patients with severe NCNSIs and can improve the prognosis dramatically. The results can provide a new effective and reasonable therapeutic strategy for patients with sNCNSIs.
摘要：
目的：严重的神经外科中枢神经系统感染（sNCNSIs）是神经外科疾病最严重的并发症之一。常规方法显示预后不良。本研究旨在分析在抗生素冲洗治疗的帮助下sNCNSI中真空辅助闭合（VAC）的临床特征。患者和方法：对诊断为sNCNSI的患者进行回顾性研究。清创术后将VAC装置放置在切口上，并在VAC组中用抗生素冲洗手术腔。对照组在清创术后对手术腔进行引流。对医疗数据进行审查和分析。结果:28例患者符合纳入标准,其中VAC组18例,对照组10例。基本医疗数据没有差异。从24例（85.7%）患者中分离出细菌。VAC组治愈率明显高于对照组(p<0.05)。多药耐药（MDR）感染患者的治愈率明显高于接受VAC治疗的患者（p<0.05）。Glasgow预后评分(GOS)两组间差异有统计学意义(p<0.05)。随访期间VAC组无再感染发生。结论：VAC辅助抗生素灌洗治疗重症NCNSI患者安全有效，可明显改善预后。研究结果可为sNCNSIs患者提供一种有效合理的治疗策略。
