颅内动脉瘤术后并发颅内感染的临床因素分析  

Clinical analysis of intracranial infection after operation of intracranial aneurysm

作　　者：许国文[1] 孙艳云 韩振波 魏玲[1] 李军[1] 陈永新 赵洪亮[1] 宋金和[1] 韩华柱 Xu Guowen;Sun Yanyun;Han Zhenbo;Wei Ling;Li Jun;Chen Yongxin;Zhao Hongliang;Song Jinhe;Han Huazhu(Department of Neurosurgery,Huanghua People’s Hospital,Huanghua 061100,Hebei Province,China)

机构地区：[1]黄骅市人民医院神经外科,河北黄骅061100

出　　处：《中华神经创伤外科电子杂志》2020年第3期161-165,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：河北省卫生厅重点科技研究计划(20171196)。

摘　　要：目的分析颅内动脉瘤术后并发颅内感染的临床危险因素,探究脑脊液(CSF)指标与血清学指标在颅内感染的临床应用价值。方法回顾性研究河北省黄骅市人民医院神经外科自2014年8月至2016年3月收治的213例颅内动脉瘤手术患者,按照感染与否分为颅内感染组28例、非颅内感染组185例。对比2组患者的临床基线资料,多因素Logistic回归分析法分析颅内感染的危险因素;对比2组患者的CSF指标、血清学指标并分析其与颅内感染的相关性。结果多因素Logistic回归分析显示,糖尿病、术中动脉瘤破裂、术中CSF漏、术中出血量和手术时间>4 h为颅内感染的独立危险因素。颅内感染组的CSF水平、血清学指标水平均高于非颅内感染组,且患者的CSF指标、血清学指标与颅内感染呈现正相关。结论患者的糖尿病、术中动脉瘤破裂、术中CSF漏、术中出血量100 mL以上、手术时间>4 h均为术后颅内感染的危险因素,对患者的CSF指标与血清学指标的检测可协助颅内动脉瘤术后并发颅内感染的诊断。Objective To analyze the clinical risk factors of intracranial infection after operation of intracranial aneurysm and to explore the clinical application value of cerebrospinal fluid(CSF)and serum indexes in intracranial infection.Methods A retrospective study was conducted on 213 patients with intracranial aneurysms treated in neurosurgery department of Huanghua People’s Hospital from August 2014 to March 2016.According to be infected or not,they were divided into two groups:28 patients with intracranial infection and 185 patients without intracranial infection.The clinical baseline data of the two groups were compared,and the risk factors of intracranial infection were analyzed by multivariate Logistic regression analysis.The CSF index and serological index of the two groups were compared.The correlation between the two groups and intracranial infection was analyzed by Spearman correlation test.Results Multivariate Logistic regression analysis showed that diabetes mellitus,ruptured aneurysm,CSF leakage,intraoperative hemorrhage over 100 mL and operation time>4 h were independent risk factors for intracranial infection.The level of CSF and serum in the intracranial infection group was higher than that in the non intracranial infection group,and there was a positive correlation between CSF and serum and intracranial infection.Conclusion Hyperglycemia,ruptured aneurysm,CSF leakage,intraoperative hemorrhage over 100 mL and operation time over 4 h are all risk factors of postoperative intracranial infection.The detection of CSF and serological indexes can help the diagnosis of postoperative intracranial infection of intracranial aneurysm.

关 键 词：颅内动脉瘤术 颅内感染 脑脊液指标 血清学指标 

分 类 号：R651.1[医药卫生—外科学]