脑外伤术后继发颅内感染的相关因素分析

目的探讨分析脑外伤开颅术后颅内感染发生的相关危险因素。方法回顾性分析2004年11月-2010年11月因脑外伤行手术治疗的643例患者的临床资料,对发生颅内感染的患者(感染组)与未感染(非感染组)患者进行对比分析。结果脑外伤开颅术后颅内感染发生率为7.9%;细菌检出率占感染的41.2%;脑外伤开颅术后颅内感染的发生与术前GCS评分、高龄、开放性脑损伤、短期内≥5次手术、切口脑脊液漏、连续两侧开颅术、长时间手术(>5h)、术后低蛋白血症及急诊手术等因素有相关性(P<0.05)。结论脑外伤开颅术后颅内感染多发生在重型脑外伤术后,手术次数和切口脑脊液漏、手术时间等是脑外伤术后颅内感染发生的高危因素;对具有高危因素的患者应给予更密切观察及预防性处理。

Correlative factors for secondary intracranial infections after brain trauma operation

OBJECTIVE To discuss the risk factors for intracranial infections following brain trauma operation.METHODS The clinical data of 643 patients who underwent brain trauma surgery from Nov 2004 to Nov 2010 were retrospectively analyzed,the patients with intracranial infections(infection group) were compared with the patients without infections(non-infection group).RESULTS The incidence of intracranial infections after craniotomy for brain trauma was 7.9%;the bacteria causing infections accounted for 4.2%;the incidence of postoperative infections following brain trauma surgery was related to preoperative GCS,advanced age of patients,open brain injury,5 times or more operation in short time,cerebrospinal leak of nick,successive double-lateral craniotomies,long-time operation(>5 h),postoperative hypoproteinemia,and emergency operation.(P<0.05).CONCLUSION The intracranial infections after craniotomy for brain trauma frequently occur in patients with severe brain trauma,the frequency of the operation,the leak of cerebrospinal fluid from incision,and the length of operation time are the high-risk factors for intracranial infections following brain trauma operation;for the patient with the high-risk factors,it is necessary to perform the close observation and prophylactic treatment.