神经外科清洁切口开颅术后手术部位感染发病率及危险因素的前瞻性研究  

Prospective study on the incidence and risk factors of infections at the surgical site after craniotomy in neurosurgical clean incision

作　　者：郑洪 黎军 谢仁恒 孙光胜 刘林鹤 蒋伟 邓天贵 吴加志 Zheng Hong;Li Jun;Xie Renheng;Sun Guangsheng;Liu Linhe;Jiang Wei;Deng Tiangui;Wu Jiazhi(People's Hospital of Fenggang County,Zunyi City,Guizhou Province,Guizhou Zunyi 564200)

机构地区：[1]贵州省遵义市凤冈县人民医院,贵州遵义564200

出　　处：《中国社区医师》2020年第28期76-77,共2页Chinese Community Doctors

摘　　要：目的:探讨神经外科清洁切口开颅术后手术部位感染的发病率及危险因素。方法:选取2018年1月-2020年1月神经外科清洁切口开颅手术患者180例,对术后手术部位感染情况进行监测,同时通过单因素、多因素回顾分析影响手术部位感染情况的相关因素。结果:术后感染发生率为12.22%。多因素回归分析发现,影响手术部位感染的危险因素包括术后再次手术、手术时间≥4 h、放置引流时间≥4 d、急诊手术。而保护性因素为术后放置硬膜下/硬膜外引流管(<72 h)。结论:为减少神经外科清洁切口开颅术后手术部位感染情况,应将手术时间缩短,防止术后再次进行手术,强化管理急诊手术,必要的情况下在手术结束后对硬膜下/硬膜外引流管进行妥善放置,但需要注意将引流管尽早拔除。Objective:To investigate the incidence and risk factors of surgical site infection after neurosurgery clean incision craniotomy.Methods:From January 2018 to January 2020,180 cases of patients with neurosurgical clean incision craniotomy were enrolled,the infection of surgical site after surgery was monitored,the factors that affected the infection of surgical site were retrospectively analyzed by single and multi-factor.Results:The incidence of postoperative infection was 12.22%.Multivariate regression analysis showed that the risk factors of infection included reoperation after operation,operative time≥4 h,drainage time≥4 d,emergency surgery.And protective factors were postoperative placement of a subdural/epidural drainage tube(less than 72 h).Conclusion:In order to reduce the infection of the surgical site after craniotomy in clean incision of neurosurgery,the operative time should be shortened and prevent re-operation after the operation and strengthen the management of emergency operation,place the subdural/epidural drainage tube properly after the operation if necessary,but attention should be paid to remove the drainage tube as early as possible.

关 键 词：神经外科 清洁切口开颅术 手术部位感染 发病率 危险因素 

分 类 号：R651.1[医药卫生—外科学]