脑积水脑室腹腔分流术后医院感染危险因素  

Risk factors of nosocomial infection after ventriculo-peritoneal shunt for hydrocephalus

作　　者：徐朋 郭璇 张芳 吕靖怡 石穗岩 卞炳皓 刘志云 王丽丽 XU Peng;GUO Xuan;ZHANG Fang;LYU Jing-yi;SHI Sui-yan;BIAN Bing-hao;LIU Zhi-yun;WANG Li-li(The First Hospital Affiliated with Shandong First Medical University,Jinan,Shandong 250014,China)

机构地区：[1]山东第一医科大学第一附属医院,山东济南250014

出　　处：《中华医院感染学杂志》2024年第7期1031-1034,共4页Chinese Journal of Nosocomiology

基　　金：山东省医务职工科技创新计划项目,山东省医药卫生科技发展基金资助项目(2018WS099);山东省重点研发计划(软科学)项目(2019RKB14038)。

摘　　要：目的探讨脑室腹腔分流手术术后医院感染相关危险因素及病原学特点。方法选择2018年1月-2023年6月在山东第一医科大学第一附属医院行脑室腹腔分流术的患者418例行目标性监测,收集患者的人口学信息与临床诊疗资料,采用单因素和多因素Logistic回归方法分析患者医院感染的危险因素并描述感染患者病原菌的分布特点。结果418例行脑室腹腔分流术的患者感染47例,感染率11.24%;多因素Logistic回归分析结果表明:术前气管切开,穿刺部位为额角及手术风险分级较高是腹腔分流术患者医院感染的危险因素(P<0.05);感染患者感染部位以呼吸系统、手术部位及泌尿系统为主,分别占比60.00%、16.37%与12.73%。结论术前气管切开,穿刺部位为额角及手术风险分级较高是脑室腹腔分流术后感染的高危因素,应针对以上因素采取相应的预防措施。OBJECTIVE To explore the related risk factors and pathogenic characteristics of nosocomial infection af-ter ventriculoperitoneal shunt.METHODS A total of 418 patients undergoing ventriculo-peritoneal shunt in the First Affiliated Hospital of Shandong First Medical University from Jan 2018 to Jun 2023 were enrolled for targe-ted monitoring.The demographic information and clinical data of patients were collected.Univariate and multivari-ate logistic regression analysis was used to analyze the risk factors for the infection.The distribution characteristics of pathogens was described.RESULTS Among 418 patients after ventriculoperitoneal shunt,47 patients were in-fected,with the infection rate of 11.24%.Multivariate logistic regression analysis showed that preoperative trach-eotomy,frontal angle puncture site,and higher surgical risk grade were risk factors for nosocomial infection in pa-tients undergoing ventriculoperitoneal shunt(P<0.05).The main sites of nosocomial infection were respiratory system,surgical site and urinary system,accounting for 60.00%,16.37%and 12.73%respectively.CONCLUSION Preoperative tracheotomy,frontal puncture site,and higher surgical risk grade are high risk factors for infection after ventriculoperitoneal shunt.Targeted preventive measures should be taken into consideration.

关 键 词：脑积水 脑室腹腔分流术 医院感染 危险因素 感染部位 病原菌 术后感染 

分 类 号：R619.3[医药卫生—外科学]