探讨脑积水合并颅内感染的治疗策略。

选择自陆军总医院附属八一脑科医院2011年1月至2014年8月18例脑积水合并颅内感染的病例，其中15例需要行脑脊液外引流术，3例间断行腰椎穿刺控制颅内压，10例轻中度感染者只予以单纯静脉抗感染治疗，8例感染较重者应用鞘内注射抗生素+静脉抗感染联合治疗。感染控制后6例行内镜第三脑室底造瘘术，11例行分流手术，1例放弃治疗，比较内镜治疗组及分流治疗组间感染控制的天数、二重感染发生率及总体并发症发生率，利用SPSS 16.0统计分析软件对资料进行统计。

感染控制后6例行内镜第三脑室底造瘘术，11例行分流手术，1例放弃治疗，内镜治疗组感染控制的天数平均（14.6±1.7）d，二重感染率为0，术后并发症发生率为33.33%，分流治疗组感染控制的天数平均（22.3±3.4）d，二重感染率为18.2%，术后并发症发生率为45.45%。内镜治疗组及分流治疗组间感染控制的天数及二重感染率有明显差异（P<0.05），而术后并发症总发生率没有明显差异（P>0.05）。

脑积水合并颅内感染治疗难度大，并发症多，在控制感染、避免二重感染发生率方面内镜手术较分流手术有优势，内镜手术应作为脑积水合并颅内感染的首选治疗方法。

To explore the treatment strategy of hydrocephalus associated with intracranial infection.

To choose 18 patients with hydrocephalus associated with intracranial infection, in the affiliated Bayi Brain Hospital, The PLA Army General Hospital between January 2011 and August 2014. Of which 15 cases need for cerebrospinal fluid drainage, 3 cases need lumbar puncture intermittently in order to control intracranial pressure, 10 cases with mild to moderate infection only be treated with antibiotic by simple intravenous ways, 8 severe cases with both intraventricular injection and intravenous methods. After infection was controlled, 6 cases were treated by ETV, 11 cases were treated by shunt operation and 1 cases gave up treatment.To contrast the number of days of infection controlled, double infection incidence and overall incidence of complications of two groups,SPSS 16.0 statistical analysis software was applled to analyze datas. Measurement data and the count data was expressed with mean+standard deviation (±s) and rate seperatelly. Rates were compared using chi square test, if P<0.05, the difference had statistically significant.

After the infection was controlled, 6 cases underwent ETV operations, 11 cases underwent shunt operations, 1 case of abandoning treatment. The endoscopic treatment groups controlled infection in average(14.6±1.7) days, double infection rate was 0, the incidence of postoperative complications was 33.33%, shunt treatment group controlled infection in average (22.3±3.4) days, double infection rate was 18.2%, the incidence of postoperative complications was 45.45%. There were obvious difference in the number of days before the infection was controlled,and double infection rate between endoscopic treatment group and shunt treatment groups (P<0.05) .The incidence of postoperative complications was no significant difference between the two groups (P>0.05) .

Hydrocephalus associated with intracranial infection had more complications and was difficult to treate.Endoscopic sugery had more superiority in controlling infection, avoiding double infection incidence. Endoscopic surgery should be selected as the first treatment for hydrocephalus associated with intracranial infection.