外伤性脑脊液漏并发颅内感染的危险因素研究  

Risk factors of intracranial infection in patients with traumatic cerebrospinal fluid fistula

作　　者：黄欢 茅帅东 秦家骏 陈先震 HUANG huang;MAO Shuaidong;QIN Jiajun;CHEN Xianzhen(Department of Neurosurgery,Chongming Branch of Shanghai Tenth People s Hospital,Shanghai 202157,China;Department of Neurosurgery,Tenth People s Hospital,School of Medicine,Tongji University,Shanghai 200072,China)

机构地区：[1]上海市第十人民医院崇明分院神经外科,上海202157 [2]同济大学附属第十人民医院神经外科,上海200072

出　　处：《同济大学学报（医学版）》2024年第1期87-93,共7页Journal of Tongji University(Medical Science)

基　　金：上海市崇明区“可持续发展科技创新行动计划”项目(CKY2020-28)。

摘　　要：目的 探讨外伤性脑脊液漏并发颅内感染的危险因素。方法 选取2013年1月—2022年12月在上海市第十人民医院崇明分院收治并进行治疗的外伤性脑脊液漏患者418例,回顾性分析其一般情况、脑脊液漏持续时间、治疗情况以及外伤性脑脊液漏并发颅内感染情况,并采用Logistic回归构建颅内感染是否发生的预测模型。结果 418例外伤性脑脊液漏患者中,18例患者发生颅内感染,感染比例4.31%。其中脑脊液漏时间、是否预防使用广谱抗生素在感染组与未感染组存在统计学差异(P<0.05)。多因素Logistic回归分析显示,脑脊液漏时间≥14 d是外伤性脑脊液漏并发颅内感染的独立危险因素(P<0.05)。构建的颅内感染预测模型AUC为0.704,预测效果良好。结论 脑脊液漏持续时间≥14 d是外伤性脑脊液漏并发颅内感染的独立危险因素。Objective To investigate the risk factors of intracranial infection in patients with traumatic cerebrospinal fluid fistula.Methods A total of 418 patients with traumatic cerebrospinal fluid fistula admitted in Chongming Branch of Shanghai Tenth Hospital from January 2013 to December 2022 were enrolled.The risk factors of intracranial infection complicating cerebrospinal fluid fistula were analyzed with multivariate Logistic regression.Logistic regression was used to construct the prediction model of intracranial infection.Results Among 418 patients,the intracranial infection occurred in 18 cases(4.31%).There were significant differences in the duration of CSF fistula and the use of broad-spectrum antibiotics between the infected group and non-infected group(P<0.05).Multivariate Logistic regression analysis suggested that CSF fistula duration ≥14 d was an independent risk factor for intracranial infection(P<0.05).A prediction model based on the risk factors was established,the area under ROC curve(AUC) of the prediction model was 0.704,and the prediction effect was good.Conclusion CSF fistula duration ≥14 d is an independent risk factor for intracranial infection in patients with traumatic CSF fistula.

关 键 词：外伤性脑脊液漏 颅内感染 危险因素 

分 类 号：R651.1[医药卫生—外科学]