标准化手术方案减少脑室-腹腔分流术后感染的临床研究  

A standardized Protocol for Reducing Ventriculoperitoneal Shunt Infection: A Clinical Research

作　　者：徐柯贝[1] 胡婉湘[2] 

机构地区：[1]广西壮族自治区人民医院神经外科,南宁市530021 [2]广西卫生职业技术学院基础部生理教研室,南宁市530021

出　　处：《广西医学》2013年第9期1142-1144,1155,共4页Guangxi Medical Journal

基　　金：广西卫生厅科研立项课题(Z2012269)

摘　　要：目的制订脑室-腹腔分流术标准化手术方案,观察其术后感染率。方法参考相关文献并结合本科室经验,制订标准化脑室-腹腔分流术手术方案治疗脑积水235例次(研究组),采用常规脑室-腹腔分流手术治疗脑积水117例次(对照组)。比较两组术后感染率并分析感染相关因素。结果研究组术后感染率为6.0%(14/235),明显低于对照组的12.8%(15/117)(P<0.05);研究组中以脑室外引流术后(有或无外引流后感染)再接受分流术患者的感染率最高(P<0.05)。logistic回归分析发现,采用抗生素可吸收缝线缝合伤口患者感染风险更高(OR=4.53,95%CI:1.43～14.41,P=0.010)。结论脑室-腹腔分流术标准化手术方案可有效降低术后感染率;抗生素可吸收缝线是术后感染的危险因素。Objective To develop a standardized protocol for ventriculoperitoneal shunt,and to reduce the postoperative infection rate.Methods The standardized protocol was developed based on the reference of the related literatures and prior institutional experience,which was applied to 235 procedures undergoing a ventriculoperitoneal shunt（research group）,the regular protocol was applied to 117 procedures（control group）.A comparison of postoperative infection rate was done between two groups,and the related factors were analyzed.Results The postoperative infection rate in the research group was 6.0%（14 /235）,which was significantly lower than that in the control group [12.8%（15/117） ]（P 0.05）;Patients undergoing shunt surgery after external ventricular drainage（with or without prior infection） had the highest infection rate in the research group（P 0.05）.Logistic regression analysis suggested that the use of antibiotic-impregnated absorbable suture was associated with an increased risk of infection[OR = 4.53,95% confidence interval（CI） ： 1.43-14.41,P = 0.010].Conclusion The standardized protocol for ventriculoperitoneal shunt significantly reduces the postoperative infection rate;The use of antibiotic-impregnated absorbable suture is the risk factor of postoperative infection.

关 键 词：脑积水 脑室腹腔分流术 感染率 标准化手术方案 

分 类 号：R651.1[医药卫生—外科学]