脑动脉瘤患者夹闭术后颅内感染的病原菌及危险因素  

Etiological characteristics and risk factors for postoperative intracranial infection in cerebral aneurysm patients undergoing clipping surgery

作　　者：任楠[1] 李耀妍 王璐 REN Nan;LI Yao-yan;WANG Lu(Tianjin Huanhu Hospital,Tianjin 300350,China)

机构地区：[1]天津市环湖医院感染管理科,天津300350 [2]天津市环湖医院手术室,天津300350

出　　处：《中华医院感染学杂志》2024年第9期1349-1352,共4页Chinese Journal of Nosocomiology

基　　金：天津市自然科学基金资助项目(21JCYBJC00450)。

摘　　要：目的探究脑动脉瘤患者夹闭术后颅内感染的病原菌特点及危险因素。方法回顾性分析天津市环湖医院2019年1月-2023年5月收治的370例行脑动脉瘤夹闭手术患者的临床资料,分为并发颅内感染组51例和未并发颅内感染组319例,分析脑动脉瘤患者夹闭术后颅内感染病原菌分布特点及危险因素。结果370例脑动脉瘤夹闭术后患者中并发颅内感染为51例,感染率为13.78%;共培养出44株病原菌,其中27株革兰阳性菌(61.36%),主要为人葡萄球菌,17株革兰阴性菌(38.64%),主要为肺炎克雷伯菌;术中出血量>100 ml、腰大池引流、脑室外引流、引流管置管时间、住院时间为脑动脉瘤患者夹闭术后颅内感染的独立危险因素(P<0.05)。结论脑动脉瘤患者夹闭术后颅内感染以人葡萄球菌和肺炎克雷伯菌为主,脑动脉瘤患者夹闭术后颅内感染危险因素包括术中出血量>100 ml、腰大池引流、脑室外引流、引流管置管时间、住院时间,临床可进行针对性防治以降低脑动脉瘤患者夹闭术后颅内感染的发生风险。OBJECTIVE To explore the etiological characteristics and risk factors for postoperative intracranial infection in the cerebral aneurysm patients undergoing clipping surgery.METHODS The clinical data were collected from 370 cerebral aneurysm patients who underwent clipping surgery in Tianjin Huanhu Hospital from Jan 2019 to May 2023 and were retrospectively analyzed.51 patients were complicated with intracranial infection and were assigned as the infection group,and 319 patients were not complicated with intracranial infection and were assigned as the no infection group.The etiological characteristics and risk factors for the postoperative intracranial infection in the cerebral aneurysm patients were observed.RESULTS Of the 370 cerebral aneurysm patients who underwent clipping surgery,51 were complicated with intracranial infection,with the infection rate 13.78%.Totally 44 strains of pathogens were isolated,27(61.36%)of which were gram-positive bacteria,and 17(38.64%)were gram-negative bacteria;Staphylococcus hominis was the predominant species of gram-positive bacteria,and Klebsiella pneumoniae was dominant among the gram-negative bacteria.Intraoperative blood loss volume more than 100ml,lumbar cerebrospinal fluid drainage,external ventricular drainage,drainage tube indwelling time and length of hospital stay were the independent risk factors for the postoperative intracranial infection in the cerebral aneurysm patients undergoing clipping surgery(P<0.05).CONCLUSION S.homonis and K.pneumoniae are the predominant species of pathogens isolated from the cerebral aneurysm patients with intracranial infection after the clipping surgery.The risk factors for the postoperative intracranial infection include the intraoperative blood loss volume more than 100ml,lumbar cerebrospinal fluid drainage,external ventricular drainage,drainage tube indwelling time and length of hospital stay.It is necessary for the hospital to take targeted prevention and treatment measures so as to reduce the risk of postoperative intracranial inf

关 键 词：脑动脉瘤 夹闭手术 颅内感染 病原菌 危险因素 术后感染 

分 类 号：R619[医药卫生—外科学]