长程皮下隧道及常规脑室外引流术后感染率比较及颅内感染危险因素分析  

Infection rate after long-tunneled external ventricular drainage versus conventional external ventricular drainage and risk factors for intracranial infection

作　　者：王垲 王雨涛 沈光建 冀建文 程塞宇 张云东 Wang Kai;Wang Yutao;Shen Guangjian;Ji Jianwen;Cheng Saiyu;Zhang Yundong(Department of Neurology Center,The Third Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属第三医院神经疾病中心,重庆401120

出　　处：《重庆医科大学学报》2025年第3期409-415,共7页Journal of Chongqing Medical University

摘　　要：目的:探讨长程皮下隧道脑室外引流(long tunneled external ventricular drainage,LTEVD)与常规脑室外引流(external ventricular drainage,EVD)术后颅内感染率的差异,并分析患者颅内感染危险因素。方法:回顾性分析2020年1月至2022年12月重庆医科大学附属第三医院神经疾病中心收治的45例实施脑室外引流患者的临床资料。其中13例行LTEVD治疗(LTEVD组),32例行常规EVD治疗(EVD组)。记录2组的一般资料、术后引流管并发症及术后管理等,探讨其对降低颅内感染率的效果,并根据术后是否发生颅内感染分为感染组(n=10)及非感染组(n=35),分析临床资料探讨颅内感染的危险因素。结果:LTEVD组引流管置管天数继发感染率为2.40‰(1/417),低于EVD组引流管置管天数继发感染率27.19‰(9/331)(P=0.009)。LTEVD组置管时间14~85 d[27.00(22.50,36.50)d]长于EVD组置管时间8~22 d[9.00(8.00,11.50)d](P=0.000)。多因素logistic回归分析结果显示脑脊液取样次数是脑室外引流患者术后颅内感染的独立危险因素,使用LTEVD治疗是脑室外引流术后颅内感染的保护因素(P<0.05)。结论:LTEVD较传统EVD可安全延长置管时间并降低脑室外引流患者术后颅内感染率,使用LTEVD术式、降低脑脊液采样频率可以减少患者术后颅内感染的风险。Objective:To investigate the difference in intracranial infection rate between long-tunneled external ventricular drainage(LTEVD)and conventional external ventricular drainage(EVD),as well as the risk factors for intracranial infection.Methods:A retrospective analysis was performed for the clinical data of 45 patients who were admitted to Department of Neurology Center,The Third Affiliated Hospital of Chongqing Medical University,from January 2020 to December 2022 and underwent EVD,among whom 13 patients underwent LTEVD(LTEVD group)and 32 patients underwent conventional EVD(EVD group).Related data were recorded for both groups,including general information,postoperative catheter-related complications,and postoperative management,to investigate the effect on reducing the rate of intracranial infection.According to the presence or absence of intracranial infection after surgery,the patients were divided into the infection group with 10 patients and non-infection group with 35 patients,and related clinical data were analyzed to investigate the risk factors for intracranial infection.Results:The LTEVD group had a significantly lower secondary infection rate of catheterization days than the EVD group[2.40‰(1/417)vs.27.19‰(9/331),P=0.009].The duration of catheterization was 14-85 days[27.00(22.50,36.50)days]in the LTEVD group and 8-22 days[9.00(8.00,11.50)days]in the EVD group,suggesting that the LTEVD group had a significantly longer duration of catheterization than the EVD group(P=0.000).The multivariate logistic regression analysis showed that the times of cerebrospinal fluid sampling was an independent risk factor for postoperative intracranial infection in patients undergoing EVD,and the use of LTEVD was a protective factor against intracranial infection after EVD.Conclusion:Compared with conventional EVD,LTEVD can safely prolong the duration of catheterization and reduce the rate of postoperative intracranial infection in patients undergoing EVD.The use of LTEVD procedure and the reduction in the times of cer

关 键 词：引流术 脑脊髓液分流术 导管相关感染 长程皮下隧道脑室外引流 危险因素 

分 类 号：R651.1[医药卫生—外科学]