颅脑手术后颅内感染危险因素分析及预防  

Risk factors of intracranial infections after brain surgery and prevention measures

作　　者：高俊红[1] 刘猛[1] 马欢[1] 

机构地区：[1]新乡市中心医院神经外科,河南新乡453000

出　　处：《中华医院感染学杂志》2013年第16期3901-3902,3905,共3页Chinese Journal of Nosocomiology

基　　金：新乡市重点科技攻关计划项目(S10012)

摘　　要：目的分析颅脑手术后颅内感染危险因素,并探讨临床预防措施,为临床工作提供借鉴。方法选取医院2009年5月-2012年5月行颅脑手术后出现颅内感染患者40例,设为观察组,并以同期未出现颅内感染患者60例设为对照组,进行颅内感染可能危险因素单变量分析,之后进一步行logistic多变量回归分析。结果患者手术时间对照组为(3.2±0.8)h、观察组为(4.7±1.0)h;对照组脑脊液外漏、后颅窝手术、有创机械通气例数及手术次数分别15、7、1例及(1.3±0.3)次;观察组患者分别为26、21、6例及(1.5±0.4)次、两组患者组间比较差异有统计学意义(P<0.05);经logistic多变量回归分析证实,手术时间、脑室外引流、脑脊液外漏及后颅窝手术是行颅脑手术患者颅内感染独立危险因素。结论手术时间长、脑室外引流、脑脊液外漏及行后颅窝手术易诱发颅脑手术后颅内感染;临床医师应当注意缩短手术时间,加强无菌操作及抗菌药物预防应用,以有效降低颅脑手术后颅内感染发生风险。OBJECTIVE To analyze the risk factors of intracranial infections after brain surgery and explore the clinical prevention measures so as to guide the clinical treatment.METHODS A total of 40cases of patients who underwent brain surgery in the hospital from May 2009to May 2012and were with intracranial infections were chosen as the observation group,while 60cases of patients without intracranial infections were set as the control group,then the univariate analysis of the risk factors for intracranial infections was performed,and the multivariate logistic regression analysis was performed.RESULTS The operation duration was（3.2±0.8）h in the control group,the observation group（4.7±1.0）h;there were 15cases of patients with cerebrospinal fluid leaks,7cases undergoing posterior fossa surgery,1case undergoing invasive mechanical ventilation,and（1.3±0.3）times of surgery,and there were 26cases of patients with cerebrospinal fluid leaks,21cases undergoing posterior fossa surgery,6cases undergoing invasive mechanical ventilation,and（1.5±0.4）times of surgery,the difference between the two was significant（P0.05）.The multivariate logistic regression analysis showed that the operation duration,ventricular drainage,cerebrospinal fluid leakage,and posterior fossa surgery were defined as the independent risk factors for intracranial infections of patients undergoing brain surgery.CONCLUSION The long operation duration,ventricular drainage,cerebrospinal fluid leakage,and posterior fossa surgery are the predisposing factors for the intracranial infections in the patients undergoing brain surgery;it is necessary for the clinicians to shorten the operation duration and intensify the aseptic operation and the prophylaxis of use of antibiotics so as to reduce the risk of intracranial infections after brain surgery.

关 键 词：颅脑手术 颅内感染 危险因素 预防 

分 类 号：R619.3[医药卫生—外科学]