颅脑术后患者颅内感染因素及CT和MRI诊断价值分析  

Analysis of Intracranial Infection Factors and Diagnostic Value of CT and MRI in Patients after Craniocerebral Surgery

作　　者：张弘强 李如兟 吴明敏 苏远东 ZHANG Hongqiang;LI Rushen;WU Mingmin;SU Yuandong(Department of Neurosurgery,Fangchenggang First People’s Hospital,Fangchenggang 538021,Guangxi,P.R.China)

机构地区：[1]防城港市第一人民医院神经外科,广西防城港538021

出　　处：《影像科学与光化学》2022年第4期917-921,共5页Imaging Science and Photochemistry

摘　　要：本文探讨颅脑术后患者颅内感染因素及CT和MRI诊断价值。选取988例颅脑手术患者作为研究对象。对所有颅脑术后颅内感染患者行CT、MRI检查,分析颅脑术后患者颅内感染因素及CT和MRI诊断价值。共发出问卷988份,收回970份,其中有65例颅脑手术患者发生颅内感染,发生率为6.70%。单因素分析显示,颅脑术后患者发生颅内感染与手术时间、手术次数、术后脑脊液漏、脑室外引流、手术部位、是否合并糖尿病有关(P<0.05)。多因素Logistic回归分析显示,手术时间、手术次数、术后脑脊液漏、脑室外引流、手术部位、是否合并糖尿病为影响颅脑手术患者术后颅内感染的主要因素(P<0.05)。MRI检查对不同病原菌、不同异常类颅内感染的阳性诊断率高于CT检查(P<0.05)。因此,颅脑术后颅内感染的危险因素有手术时间、手术次数、术后脑脊液漏、脑室外引流、手术部位、是否合并糖尿病,MRI对颅内感染的诊断准确率较高。This paper investigated the factors of intracranial infection and the diagnostic value of CT and MRI in patients after craniocerebral surgery.988 patients who underwent craniocerebral surgery were selected as study subjects.Patients with intracranial infection after craniocerebral surgery were examined by CT and MRI,and then analyzed the factors of intracranial infection and the diagnostic value of CT and MRI in patients after craniotomy.988 questionnaires were sent out and 970 were returned,among them there were 65 patients with craniocerebral surgery developed intracranial infection,the incidence rate was 6.70%.As shown in univariate analysis,the occurrence of intracranial infection in patients after craniotomy was associated with operative time,number of operations,postoperative cerebrospinal fluid leakage,extraventricular drainage,surgical site,and whether comorbid diabetes mellitus(P<0.05).Multivariate Logistic regression analysis shows that the operative time,number of operations,postoperative cerebrospinal fluid leakage,extraventricular drainage,surgical site,whether comorbid diabetes mellitus were the main factors affecting postoperative intracranial infection in patients undergoing cranial surgery(P<0.05).The positive diagnostic yield of MRI examination for intracranial infection with different pathogenic bacteria and different abnormal classes was higher than that of CT examination(P<0.05).In conclusion,the risk factors of intracranial infection after craniotomy are operative time,number of surgical procedures,postoperative CSF leakage,extraventricular drainage,surgical site,whether combined with diabetes mellitus,and MRI has a high diagnostic accuracy for intracranial infection.

关 键 词：脑术 颅内感染 危险因素 CT MRI 

分 类 号：R651.1[医药卫生—外科学]