急诊开颅手术患者颅内感染的影响因素  

Influencing factors for intracranial infection in patients undergoing emergency craniotomy

作　　者：胡云华[1] 李淑艳[1] 陈林芳[1] 蒋梅英[1] 蒋飞 HU Yun-hua;LI Shu-yan;CHEN Lin-fang;JIANG Mei ying;JIANG Fei(The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University,Huaian,Jiangsu 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院感染管理处,江苏淮安223300

出　　处：《中华医院感染学杂志》2022年第2期203-206,共4页Chinese Journal of Nosocomiology

基　　金：淮安市“533英才工程”科研项目基金资助项目(HAA201741)。

摘　　要：目的 分析急诊开颅手术患者术后颅内感染的影响因素,为临床预防和控制颅内感染提供依据。方法 采用回顾性病例对照研究方法,收集2018年1月-2020年6月在南京医科大学附属淮安第一医院急诊开颅手术977例患者的临床资料,采用单因素及多因素Logistic回归分析颅内感染影响因素。结果 977例急诊开颅手术患者术后发生颅内感染46例,感染率为4.71%;脑脊液培养检出病原菌23株,检出率为50.00%,其中革兰阴性菌16株,占69.57%;多因素Logistic回归分析显示:脑脊液漏、术后引流管留置时长≥3 d、术中植入人工材料、患者年龄<60岁是急诊开颅术后并发颅内感染的独立影响因素。结论 多种因素影响急诊开颅术后颅内感染的发生,应加强急诊开颅围术期管理,准确评估患者的感染风险,及时采取干预措施,从而降低颅内感染的发生率。OBJECTIVE To explore the influencing factors for postoperative intracranial infection in patients undergoing craniotomy so as to provide guidance for clinical prevention and control of the intracranial infection. METHODS By means of retrospective case-controlled study, the clinical data were collected from 977 patients who underwent emergency craniotomy in the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University from Jan 2018 to Jun 2020. Univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the intracranial infection. RESULTS Of the 977 patients who underwent the emergency craniotomy, 46 had postoperative intracranial infection, with the infection rate 4.71%. Totally 23 strains of pathogens were isolated from cerebrospinal fluid specimens, with the isolation rate 50.00%, 16 of which were gram-negative bacteria, accounted for 69.57%. Multivariate logistic regression analysis showed that cerebrospinal fluid leakage, duration of postoperative drainage tube indwelling no less than 3 days, intraoperative implantation of artificial material and less than 60 years of age were independent influencing factors for the postoperative intracranial infection in the emergency craniotomy patients. CONCLUSION There are a variety of influencing factors for the postoperative intracranial infection in the emergency craniotomy patients. It is necessary to strengthen the management during the perioperative period of emergency craniotomy, accurately estimate the risk of infection and take intervention measures in a timely manner so as to reduce the incidence of intracranial infection.

关 键 词：急诊开颅手术 颅内感染 影响因素 

分 类 号：R651.11[医药卫生—外科学]