开颅手术及脑脊液分流术后颅内感染危险因素分析  

Analysis on Risk Factors of Intracranial Infection After Craniotomy Operation and Cerebrospinal Fluid Shunt

作　　者：刘洛同[1] 周杰[1] 明扬[1] 彭里磊[1] 陈礼刚 

机构地区：[1]泸州医学院附属医院神经外科,泸州646000

出　　处：《成都医学院学报》2015年第2期222-224,共3页Journal of Chengdu Medical College

摘　　要：目的分析开颅手术及脑脊液分流术患者术后颅内感染发生的危险因素。方法回顾性分析2011年6月至2014年6月在泸州医学院附属医院神经外科行开颅手术及脑脊液分流术患者共368例,并根据纳入标准及排除标准进行病例筛选。结果 368例患者临床资料显示,发生术后感染39例(10.6%),其中,脑膜-脑室炎38例,脑脓肿/脑积脓1例。开颅手术326例,发生术后感染35例(10.7%);脑脊液分流术42例,发生术后感染4例(9.5%)。术后感染危险因素分析发现,急诊手术、GCS评分≤9分、术后脑脊液外引流、手术时间>4h、二次手术和术后脑脊液漏是颅脑术后发生感染的危险因素(P<0.05)。结论颅脑术后发生颅内感染的危险因素有急诊手术、GCS评分较低、术后脑脊液外引流、手术时间较长、二次手术和术后发生脑脊液漏,临床上应针对危险因素,采取相应措施,降低术后颅内感染的发生率。Objective Risk factors were analyzed of intracranial infection in patients who suffered from neurosurgery craniotomy and cerebrospinal fluid shunt in our hospital. Methods A retrospective analysis was conducted in this study. The clinical data included Three hundred and sixty-eigltt cases of patients who were subjected to neurosurgery craniotomy surgery and cerebrospinal fluid shunt from June 2011 to June 2014 in our hospital. Inclusion and exclusion criteria were employed for case screen. Results Three hundred and sixty-eight cases of patients were collected, and 39 cases （10. 6%） were postoperative infection, including 38 cases of meningeal- ventricle inflammation and 1 case of encephalopyosis. The occurrence rates of postoperative infection were 35 cases （10.7 %） and 4 cases （9.5%） for 326 cases of neurosurgery craniotomy surgery and 42 cases of cerebrospinal fluid shunt,respectively. The findings of risk factor together with emergency operation,Glasgow coma score （GCS） value less than 9, cerebrospinal fluid drainage outside of postoperative, time of operation more than 4 h, a second operation, cerebrospinal fluid leakage of postoperation（P〈0.05）. Conclusion Intracranial infection after surgery is emergency operation,low GCS value, cerebrospinal fluid drainage outside of postoperation, longer time of operation, a second operation,and cerebrospinal fluid leakage of postoperation. To reduce the occurrence of intracranial infection after surgery, some steps should be taken up correspondingly.

关 键 词：开颅手术 脑脊液分流术 颅内感染 危险因素 

分 类 号：R651.11[医药卫生—外科学]