颅脑外伤患者术后感染相关因素分析  

Risk factors for postoperative infections in patients with traumatic brain injury

作　　者：杨登峰[1] 沈罡[1] 

机构地区：[1]宁波市医疗中心李惠利医院神经外科,浙江宁波315040

出　　处：《中华医院感染学杂志》2013年第24期6033-6034,6037,共3页Chinese Journal of Nosocomiology

基　　金：宁波市自然科学基金项目(2012A610195)

摘　　要：目的探讨颅脑外伤患者术后发生呼吸道及手术部位感染的相关危险因素，进一步提高临床诊治水平，以降低术后感染发生率。方法回顾性分析2008年1月-2013年1月医院因颅脑外伤行手术治疗的患者258例，观察术后患者呼吸道感染及手术部位感染情况，所有数据采用t检验或x2检验进行统计分析，用多因素logistic回归模型，采用Enter法进行回归分析，以确定各危险因素。结果258例颅脑外伤行手术治疗患者发生术后感染99例，感染率38．3％，其中有63例发生呼吸道感染，36例发生手术部位感染；经单因素分析，其中损伤类型、术后住院天数、术后有无插管、性别及有无脑室／硬膜外引流差异有统计学意义（P〈0．05），logistic回归分析显示开放性颅脑损伤（OR：1．01，95％CI：1．01～1．24）、术后住院天数长（OR：3．15，96％CI：1．48～4．62）及有术后插管（OR：2．36，95％CI：1．42～2．98）是导致术后感染的危险因素。结论多种因素导致术后感染，而减少住院天数及控制术后插管数是预防术后感染的有效途径。OBJECTIVE To explore the related risk factors for the postoperative respiratory tract infections and surgical site infections in the patients with traumatic brain surgery and further improve the clinical diagnosis and treatment so as to reduce the incidence of postoperative infections. METHODS The clinical data of 258 cases of traumatic brain injury who underwent surgery in the hospital from Jan 2008 to Jan 2013 were retrospectively analyzed, then the incidence of the postoperative respiratory tract infections and the surgical site infections was observed, all the data were statistically analyzed with the use of t-test and the chi-square test, and the multivariate logistic regression analysis was performed with the use of Enter method so as to define the risk factors. RESULTS Of totally 258 cases of traumatic brain surgery undergoing surgery, the postoperative infections occurred in 99 cases with the infection rate of 38.3%, including 63 cases of respiratory tract infections and 36 cases of surgical site infections. The univariate analysis showed that the difference in the type of trauma, postoperative hospitalization duration, postoperative catheter indwelling, gender, or ventricle or epidural drainage was statistically significant（P〈0.05）3 the multivariate logistic regression analysis indicated that the open craniocerebral trauma （OR： 1.01,95%CI： 1.01 - 1.24）, prolonged postoperative hospitalization duration（OR： 3. 15,96% CI： 1.48- 4. 62）, and postoperative catheter indwelling （OR：2.36,95 VQCI：1. 42 - 2.98） were the risk factors for the postoperative infections. CONCLUSION There are many factors leading to the postoperative infections, and it is an effective way to reduce the hospitalization duration and control the number of catheters so as to prevent the postoperative infections.

关 键 词：颅脑外伤 呼吸道 手术部位 感染 危险因素 

分 类 号：R619.3[医药卫生—外科学]