脑外伤开颅术后颅内感染的危险因素分析  

Risk Factors for Intracranial Infection following Craniotomy for Brain Trauma

作　　者：王楷[1] 袁士翔[1] 陈东朝[1] WANG Kai;YUAN Shi-xiang;CHEN Dong-chao(The Second Department of Surgery,Guangzhou Twelfth People ＇ s Hospital,Guangzhou 510620,China)

机构地区：[1]广州市第十二人民医院外二科,广州510620

出　　处：《实用临床医学（江西）》2018年第7期39-42,共4页Practical Clinical Medicine

摘　　要：目的探讨脑外伤开颅术后颅内感染的危险因素,为预防和控制颅内感染提供参考。方法根据术后是否发生颅内感染将546例行开颅手术的脑外伤患者分为颅内感染组(n=60)和未颅内感染组(n=486)。对2组的临床资料进行回顾性分析,并对术后颅内感染的危险因素采用多因素Logistic回归分析。结果颅内感染组术前格拉斯哥评分(<8、≥8分)、开放性损伤(是、否)、手术时间(≤4、>4h)、颅后窝手术(是、否)、术中置入材料(是、否)、术后切口脑脊液漏(是、否)、术后引流管放置时间(≥7、<7d)、术后空腹血糖(<7、≥7 mmol·L-1)、术后白蛋白(<25、≥25g·L-1)所占比例与未颅内感染组比较差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,术前格拉斯哥评分<8分、颅后窝手术、术中置入材料、术后引流管放置时间≥7d、术后白蛋白<25g·L-1及术后切口脑脊液漏均是术后颅内感染的危险因素。结论脑外伤开颅术后患者存在多种颅内感染的危险因素。临床应在明确相关危险因素的基础上,及时采取预防性处理措施,有助于减少脑外伤患者术后颅内感染的发生。Objective To investigate the risk factors for intracranial infection following craniotomy for brain trauma,and to provide a reference for the prevention and control of intracranial infection.Methods A total of 546 patients who underwent craniotomy for traumatic brain injury were divided into intracranial infection group（n=60）and non-intracranial infection group（n=486）.The clinical data were retrospectively analyzed and the risk factors for intracranial infection following craniotomy were analyzed using multivariate Logistic regression analysis in both groups.Results There were significant differences in Glasgow score（8,≥8）,open injury（yes,no）,operation time（≤4,4 hours）,posterior cranial fossa surgery（yes,no）,intraoperative material placement（yes,no）,postoperative cerebrospinal fluid leakage（yes,no）,postoperative drainage tube placement time（≥7,7 days）,postoperative fasting blood glucose level（7,≥7 mmol·L-1）and postoperative albumin level（25,≥25 g·L-1）between the two groups（P〈0.05）.Multivariate logistic regression analysis showed that preoperative Glasgow score 8,posterior cranial fossa operation,intraoperative material placement,postoperative drainage tube placement time≥ 7 days,postoperative albumin level25 g·L-1 and postoperative cerebrospinal fluid leakage were the risk factors for postoperative intracranial infection.Conclusion There are multiple risk factors for intracranial infection after craniotomy for traumatic brain injury.The preventive measures should be taken based on the identification of relevant risk factors to reduce the occurrence of postoperative intracranial infection in patients with traumatic brain injury.

关 键 词：脑外伤 颅内感染 开颅术 危险因素 

分 类 号：R651[医药卫生—外科学]