“四洗法”消毒预防脑室-腹腔分流术后颅内感染的效果分析  

Efficiency analysis of“four-step flushing method”disinfection in preventing intracranial infection after ventriculoperitoneal shunt

作　　者：吴小莉 王波[1] 胡昔奇[2] 夏鹰[2] WU Xiaoli;WANG Bo;HU Xiqi;XIA Ying(Operating Room,Haikou City People′s Hospital of Hainan Province,Haikou,Hainan,570208;Department of Neurosurgery,Haikou City People′s Hospital of Hainan Province,Haikou,Hainan,570208)

机构地区：[1]海南省海口市人民医院手术室,海南海口570208 [2]海南省海口市人民医院神经外科,海南海口570208

出　　处：《实用临床医药杂志》2022年第6期23-25,39,共4页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金资助项目(81760234)。

摘　　要：目的观察“四洗法”消毒预防脑积水患者行脑室-腹腔分流术后颅内感染的效果。方法收集海口市人民医院神经外科病房2011年6月—2021年6月210例脑积水行脑室-腹腔分流术患者的临床资料。2011年6月—2016年6月纳入患者113例,设为对照组;2016年7月—2021年6月纳入患者97例,设为观察组。观察组采用“四洗法”消毒,对照组采用常规备皮消毒。比较2组患者围术期颅内感染发生率、住院时间、住院费用,分析脑室-腹腔分流术后发生颅内感染的影响因素。结果对照组颅内感染发生率为15.0%,观察组感染发生率为6.2%。观察组患者住院时间、住院费用分别为(15.1±4.2)d、(48408.0±3682.0)元人民币,短于、低于对照组的(17.2±4.1)d、(54798.0±3657.0)元人民币,差异有统计学意义(P<0.05)。单因素分析结果显示,“四洗法”消毒使用情况、脑积水严重程度、手术时间是发生颅内感染的影响因素(P<0.05)。结论“四洗法”消毒可降低脑积水患者脑室-腹腔分流术后颅内感染的发生率,改善患者预后,缩短患者术后住院时间,降低并发症相关的病死率,减轻患者的经济负担。Objective To observe the effect of"four-step flushing method"disinfection on preventing intracranial infection after ventriculoperitoneal shunt in patients with hydrocephalus.Methods The clinical materials of 210 hydrocephalus patients with ventriculoperitoneal shunt in the ward of Department of Neurosurgery in Haikou City People′s Hospital from June 2011 to June 2021 were collected,113 patients from June 2011 to June 2016 were included in control group,and the 97 patients from July 2016 to June 2021 were included in observation group.The observation group was conducted with"four-step flushing method"disinfection,and the control group was conducted with routine skin preparation disinfection.Incidence of perioperative intracranial infection,hospital stay and hospitalization expenses were compared between the two groups,and the influencing factors of intracranial infection after ventriculoperitoneal shunt were analyzed.Results Incidence of intracranial infection was 15.0%in the control group and 6.2%in the observation group.The hospital stay and hospitalization expenses of the observation group were(15.1±4.2)d and(48408.0±3682.0)Yuan Renminbi(RMB),which were significantly lower than(17.2±4.1)d and(54798.0±3657.0)yuan RMB of the control group(P<0.05).Univariate analysis showed that the use of"four-step flushing method"disinfection,the severity of hydrocephalus and the operation time were the influencing factors of intracranial infection(P<0.05).Conclusion The"four-step flushing method"disinfection can reduce the incidence of intracranial infection after ventriculoperitoneal shunt in patients with hydrocephalus,improve the prognosis,shorten the postoperative hospital stay,reduce the complication-related mortality and alleviate the economic burden of patients.

关 键 词：“四洗法”消毒 脑室-腹腔分流术 脑积水 颅内感染 手术时间 

分 类 号：R782.05[医药卫生—口腔医学] R619[医药卫生—临床医学]