术后颅内感染预警准确性及危险因素研究  

Study on the Early Warning and the Risk Factors of Intracranial Infection After Neurosurgery

作　　者：李琳 宋瑞雪 韩璐[1] 汪皖君[1] LI Lin;SONG Ruixue;HAN Lu;WANG Wanjun(Department of HAI Management,Tianjin Huanhu Hospital,Tianjin 300350,China;School of Public Health,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]天津市环湖医院感染管理科,天津300350 [2]天津医科大学公共卫生学院,天津300070

出　　处：《继续医学教育》2020年第12期95-97,共3页Continuing Medical Education

基　　金：天津市医院协会医院管理研究项目(2019ZZ09)。

摘　　要：目的评估医院感染监控系统(简称"院感系统")预警神经外科术后颅内感染的准确性,分析影响术后发生颅内感染的危险因素。方法回顾性分析某三甲脑系科中心医院2019年全年收治的神经外科手术患者,计算院感系统预警的灵敏度、特异度和约登指数来评估该系统的准确性;使用倾向评分匹配按年龄和性别为术后颅内感染组(135例)匹配相应对照组(135例),利用χ~2检验、多因素条件Logistic回归分析发生术后颅内感染的危险因素。结果院感系统预警灵敏度83.7%,特异度97.0%,约登指数0.81;脑脊液漏(OR=5.39,95%CI:1.47~19.83),低蛋白血症(OR=2.43,95%CI:1.21~4.89),腰大池引流(OR=5.80,95%CI:2.43~13.86)为神经外科术后颅内感染的独立危险因素。结论院感系统预警术后颅内感染准确性较高,预警设置应符合监测科室特点;脑脊液漏、低蛋白血症、腰大池引流可增加术后颅内感染风险。Objective To evaluate the accuracy of nosocomial infection monitoring system in early warning of intracranial infection and analyze the risk factors of intracranial infection after neurosurgery.Methods A retrospective analysis of neurosurgery patients admitted to the department of brain of a third-level central hospital in 2019.The sensitivity,specificity and Youden index of the early warning system of hospital sensing system were calculated to evaluate the accuracy of the system.Propensity score matching was used to match the postoperative intracranial infection group(135 cases)with the corresponding control group(135 cases)by age and gender.χ2 test and conditional logistic regression analysis were used to analyze the risk factors of intracranial infection after neurosurgery.Results The sensitivity of early warning of the hospital sensing system was 83.7%,the specificity was 97.0%,and the Youden index was 0.81;cerebrospinal fluid leakage(OR=5.39,95%CI:1.47~19.83),hypoproteinemia(OR=2.43,95%CI:1.21~4.89),lumbar cistern drainage(OR=5.80,95%CI:2.43~13.86)was an independent risk factor for intracranial infection after neurosurgery.Conclusion The accuracy of early warning of intracranial infection after hospitalization system is high,the setting of early warning should accord with the characteristics of monitoring department;cerebrospinal fluid leakage,hypoproteinemia,and lumbar drainage can increase the risk of postoperative intracranial infection.

关 键 词：院感系统 预警 颅内感染 医院感染 危险因素 

分 类 号：R619[医药卫生—外科学]