Ⅰ类切口开颅术后颅内感染的危险因素分析  

Analysis on Risk Factors for Intracranial Infection After Type 1 Incision Craniotomy Operation

作　　者：李洪[1] 杨剑 杨晓滨[1] Li Hong;Yang Jian;Yang Xiaobin(Neoursurgery Department 1,Yibin First Peolple's Hospital,Yibin,Sichuan 644000,China)

机构地区：[1]宜宾市第一人民医院神经外1科,四川宜宾644000

出　　处：《四川医学》2023年第10期1050-1053,共4页Sichuan Medical Journal

摘　　要：目的探讨Ⅰ类切口开颅术后颅内感染的危险因素,为预防感染提供依据。方法回顾性分析2019年1月至2023年3月在我院接受Ⅰ类切口开颅手术治疗的329例患者的临床资料,采用单因素分析(卡方检验、秩和检验)、Logistic多元线性回归分析术后颅内感染的影响因素。结果329例患者术后发生颅内感染18例,感染发生率为5.47%(18/329),单因素分析结果提示是否急诊手术、是否规范预防性使用抗生素、术者有无很强无菌意识、术后是否有脑脊液切口漏、疾病类型、术中使用的手术辅助工具与开颅术后发生颅内感染相关(P<0.05),Logistic多元线性回归分析结果提示术者无很强无菌意识、术后有脑脊液切口漏、术中使用手术辅助工具是术后颅内感染的独立危险因素(P<0.05)。结论手术医师要加强无菌意识,提高无菌技术,落实无菌管理,避免术中污染,严密修补好硬脑膜,规范使用抗生素,尽量避免术后颅内感染。Objective To analyze the risk factors of intracranial infection after type 1 incision craniotomy operation and provide evidence for preventing postoperative intracranial infection.Methods The detailed clinical data of 329 patients who received type 1 incision craniotomy operation in our hospital from January 2019 to March 2023 were retrospectively analyzed.The possible risk factors of postoperative intracranial infection were carefully analyzed by single factor using anlysis,Rank sum test and multi-factor using multivariate Logistic regression.Results There were 18 cases of postoperative intracranial infection in 329 patients,and the incidence of postoperative intracranial infection was 5.47%(18/329).Single factor anlysis and Rank sum test showed that emergent operation,standerdized perioperative antibiotic,strong aseptic awareness,cerebrospinal fluid incision leakage,disease type,assistant tool for operation were related to postoperative intracranial infection(P<0.05).Multivariate Logistic regression analysis showed that surgeon without strong aseptic awareness,cerebrospinal fluid postoperative incision leakage,using assistant tool for operation were independent risk factors for postoperative intracranial infection(P<0.05).Conclusion Surgeons should strengthen the aseptic awareness,improve aseptic technology,implement aseptic management,avoid intraoperative contamination,repair the dura rigorously,standardize the use of antibiotics,and try to avoid postoperative intracranial infection.

关 键 词：开颅手术 Ⅰ类切口 术后颅内感染 中枢神经系统感染 危险因素 

分 类 号：R651.1[医药卫生—外科学]