Observation on the effect of flexible neuroendoscopy in the treatment of subdural effusion complicated with infantile purulent meningitis

Abstract

Objective To investigate the clinical effect of flexible neuroendoscopy-assisted drilling irrigation and external drainage in the treatment of subdural effusion complicated with purulent meningitis in infants. Methods A retrospective analysis was conducted on the clinical data of 40 infants with purulent meningitis complicated with subdural effusion who were admitted to the Department of Neurosurgery, Children's Hospital of Chongqing Medical University from January 2016 to December 2020. According to the different treatment methods, 40 children were divided into an endoscopy group (treated by burr hole irrigation and external drainage assisted by flexible neuroendoseopy, 20 cases) and a control group (treated by skull burr hole drainage, 20 cases). The general data, clinical manifestations, treatment-related indicators and complications of the two groups were compared. Results There was no significant difference between the endoscopy group and the control group in gender, age, course of disease, clinical manifestations, location of effusion, or preoperative cerebrospinal fluid-related indicators (all P > 0. 05). The improvement time of symptoms and cerebrospinal fluid indicator (the white blood cell count in the cerebrospinal fluid returning to the normal range) in the endoscopy group were earlier than those in the control group (postoperative symptom improvement time; 4.4 ±2. 3 d vs. 8.7 ±3.0 d; cerebrospinal fluid indicator improvement time: 6.3 ±3.5 d vs. 13. 2 ±5. 2 d). Postoperative anti-infective treatment time M (Q1, Q3 ) in the endoscopy group was shorter than that in the control group] 11.5 (8. 3, 14.0) d vs. 19.0 (14.0, 27.3) d]. All the differences above were statistically significant (P <0.001 ). In terms of postoperative complications, there were 5 cases ( 25% ) of secondary subarachnoid hemorrhage and cerebral contusion in the control group, and 0 cases (0% ) in the endoscopy group. Conclusion For purulent meningitis complicated with subdural effusion, infants treated with flexible neuroendoscopy-assisted burr hole irrigation and external drainage can achieve better clinical outcomes compared with skull burr hole drainage.