“三步消毒法”降低脑室-腹腔分流术后颅内感染率初步效果观察  

Clinical observation of“three-step disinfection”on reducing intracranial infection rate after ventriculo peritoneal shunt

作　　者：卢盛华 赵志刚[2] 王学蛟[3] 王翀昊[4] 田润发 王琳琳[4] 李晶[5] 牛非 张斌 刘佰运[1] Lu Shenghua;Zhao Zhigang;Wang Xuejiao;Wang Chonghao;Tian Runfa;Wang Linlin;Li Jing;Niu Fei;Zhang Bin;Liu Baiyun(Beijing Key Laboratory of Central Nervous System Injury and Department of Neurosurgery,Beijing Neurosurgical Institute and Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Pharmacy,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Neurosurgery,Third People’s Hospital of Datong,Datong 037008,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Operating Room of Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]北京市神经外科研究所中枢神经系统损伤研究北京市重点实验室和首都医科大学附属北京天坛医院神经外科,100070 [2]首都医科大学附属北京天坛医院药学部,北京100070 [3]大同市第三人民医院神经外科,037008 [4]首都医科大学附属北京天坛医院神经外科,北京100070 [5]首都医科大学附属北京天坛医院手术室,北京100070

出　　处：《中华神经创伤外科电子杂志》2021年第2期107-111,共5页Chinese Journal Of Neurotraumatic Surgery：Electronic Edition

基　　金：国家自然科学基金(81171144,81471238)。

摘　　要：目的评价“三步消毒法”降低脑室-腹腔(V-P)分流术患者术后颅内感染率的效果,并对出现感染的原因进行初步分析。方法前瞻性单中心临床观察首都医科大学附属北京天坛医院神经外科自2019年4月至12月行V-P分流手术患者共69例,其中男性50例,女性19例,年龄范围18~77岁,年龄(54.32±11.52)岁,所有患者均采用“三步消毒法”进行术前消毒,观察患者围术期、术后6和12个月的颅内感染情况。随访采用术后病房观察,早期门诊复查,中远期电话随访相结合的方式,随访截止日期为2020年12月。结果本组69例患者均顺利完成手术,围术期未出现颅内感染病例,术后10 d~6个月出现颅内感染患者2例,术后6个月~1年无新发颅内感染患者。术后1年内累计颅内感染发生率为2.89%。结论初步观察“三步消毒法”可以降低V-P分流术后的颅内感染发生率,值得进一步进行大样本多中心的分组研究验证。Objective To evaluate the effect of three-step disinfection on reducing intracranial infection rate in patients with ventriculo peritoneal(V-P) shunt, and analyze the causes of infection.Methods A total of 69 patients underwent V-P shunt surgery in Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University were prospectively observed in a single center from April to December 2019. There were 50 males and 19 females, ranging in age from 18 to 77 years old, with an age of(54.32±11.52) years old. All patients were disinfected with "three-step disinfection method" before operation, and the intracranial infection during perioperative period, 6 months and 12 months after operation were observed. The patients were followed up by inpatient observation, outpatient review and long-term telephone follow-up. The deadline of follow-up was December 2020. Results All the 69 patients in this study completed the operation successfully. There were no intracranial infection cases during the perioperative period. There were 2 patients experienced intracranial infection from 10 d to 6 months after operation, and no new intracranial infection patients occurred 6 months to 1 year after operation. The cumulative incidence of intracranial infection was 2.89%. Conclusion The research has preliminarily proved that the "three-step disinfection method" can reduce the incidence of intracranial infection after V-P shunt surgery, which is worthy of further validation by large sample multicenter randomized controlled trial.

关 键 词：脑室-腹腔分流术 颅内感染 术前消毒 

分 类 号：R651.1[医药卫生—外科学]