脑室出血外引流术后继发颅内感染危险因素分析  

Risk factors for intracranial infection after external ventricular drainage by Logistic regression

作　　者：沈云龙[1] 刘加令 漆松涛[1] 李伟光[1] 霍伟康[1] 杨勇[1] 王前[1] 

机构地区：[1]南方医科大学第五附属医院神经外科,广州510900 [2]中山大学附属博济医院神经外科

出　　处：《中国神经精神疾病杂志》2015年第12期705-709,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：广东省省级科技计划项目(编号:2013B021800050);广州市科技计划项目(编号:2013J4100013)资助

摘　　要：目的研究脑室出血行脑室外引流术后颅内感染的危险因素,为预防及治疗提供依据。方法对脑室出血后行脑室外引流术的367例患者进行回顾性调查,应用Logistic回归分析筛选脑室外引流术后并发颅内感染的危险因素。结果 367例患者中,发生颅内感染29例。脑室外引流管留置1周、2周、3周的感染率分别是8.19%、8.04%、7.32%,无统计学差异。而格拉斯哥昏迷(GCS)评分[OR=2.569,95%CI(1.792-3.378),P<0.05]、尿激酶灌注[OR=2.897,95%CI(1.297-5.061),P<0.05]、脑脊液抽样[OR=3.399,95%CI(2.705-4.175),P<0.01]及合并其他基础病[OR=3.751,95%CI(2.032-5.371),P<0.01]是脑室出血行脑室外引流术后颅内感染的危险因素。结论脑室外引流管留置3周内是安全的,在满足治疗需要的基础上,减少使用尿激酶灌注和脑脊液抽样,积极治疗合并基础疾病可以减少颅内感染的发生率。Objective To investigate the risk factors for intracranial infection after external ventricular drainage and provide basis for preventing and controlling the drainage-associated intracranial infection.Methedsthe clinical data from three hundred sixty-seven cases of ventricular hemorrhage patients were retrospectively analyzed, using Logistic regression to screen risk factors of intracranial infection after external ventricular drainage.ResultsThere were 29 cases with intracranial infection and infection rate was 8.19%, 8.04% and 7.32% at ventricle drainage tube indwelling1-week group, 2-week group and 3 week-group, respectively. Glasgow coma score（GCS） [OR = 2. 569 CI（1.7923.378） %, P〈0.05）, urokinase perfusion（OR = 2.897, 95% CI（1.297 5.061）, P〈0.05）, cerebrospinal fluid sampling（OR = 3.399, 95% CI（2.705 4.175）, P〈0.01] and comorbidities [OR = 3.751, 95% CI（2.032 5.371）, P〈0.01] were risk factors for ventricle drainage operation.ConclusionVentricle drainage tube indwelling 3 weeks is safe. Less use of urokinase perfusion and cerebrospinal fluid sampling and active treatment of comorbidities diseases can reduce the intracranial infection incidence of external ventricular drainage after Intraventricular hemorrhage.

关 键 词：颅内感染 危险因素 脑室外引流 脑室内出血 

分 类 号：R651.1[医药卫生—外科学]