小儿神经外科幕上手术后颅内感染的发生率及危险因素调查  

A retrospective analysis of post-craniotomy intracranial infection in pediatric patients with supratentorial neurosurgical operation:incidence,risk factors and outcome

作　　者：徐明[1] 史中华[1] 陈光强[1] 赵经纬[1] 石广志[1] 王韬[2] 王鑫[2] 唐明忠[3] 周建新[1] 

机构地区：[1]首都医科大学附属北京天坛医院重症监护病房国家神经系统疾病临床医学研究中心,北京100050 [2]首都医科大学附属北京天坛医院信息中心国家神经系统疾病临床医学研究中心,北京100050 [3]首都医科大学附属北京天坛医院检验科国家神经系统疾病临床医学研究中心,北京100050

出　　处：《首都医科大学学报》2015年第3期454-458,共5页Journal of Capital Medical University

摘　　要：目的调查首都医科大学附属北京天坛医院小儿神经外科幕上手术患者术后颅内感染的发生率,危险因素及转归。方法选择2011年至2012年行小儿神经外科幕上手术患者487例。回顾性分析患者病例资料、实验室结果报告及影像学等信息,得出术后颅内感染的发生率、危险因素和转归。结果本院小儿神经外科幕上手术患者术后颅内感染的发生率为8.0%。术后留置引流管和术后头部CT显示颅内出血为危险因素(OR<l,P<0.05)。感染组患者与非感染组患者的住院时间、住院花费差异有统计学意义(P<0.05)。肺部感染发生率在感染组明显多于非感染组(P<0.05)。预防性使用抗生素未见明显保护作用(P>0.05)。结论本院小儿神经外科幕上手术患者术后颅内感染的发生率为8.0%,感染患者的住院时间及花费明显增加,应当给予足够重视。对于预防性使用抗生素降低颅内感染发生率的作用尚需进一步研究证实。Objective To investigate the incidence,risk factors and outcomes of post-craniotomy intracranial infection（PCII） in pediatric patients with supratentorial neurosurgical operation in our hospital.Methods Pediatric patients who were undergone supratentorial neurosurgical operation in our hospital from 2011 to 2012 were included.The medical records,imaging findings,and laboratory were reviewed for investigating the incidence,risk factors,and outcomes of patients had PCII.Results The incidence of PCII was 8.0%.Postoperative drainage tube placement,and postoperative head CT showing intracranial hemorrhage were independent risk factors for PCII（odds ratio 〈 1,P 〉 0.05）.Administration of prophylactic antibiotics did not reduce the incidence of PCII.Conclusion The overall incidence of PCII was 8.0%.Patients with PCII had longer hospital stay and higher hospital cost,indicating that patients with PCII should be carefully managed.

关 键 词：小儿神经外科手术 幕上手术 颅内感染 预防性抗生素应用 危险因素 

分 类 号：R651[医药卫生—外科学]