神经外科术后颅内感染的临床分析

目的 探讨神经外科术后颅内感染的危险因素、预防和治疗方法.方法 回顾分析我院2009年4月至2012年4月1 432例神经外科手术患者中89例发生颅内感染的临床资料,对影响感染率的各项因素进行分析,并观察其治疗效果.结果 患者术后颅内感染与手术部位、手术时间≥4 h、脑室外引流、留置引流管时间、脑脊液漏有关（P ＜0.05或P＜0.01）,与年龄、性别、术前是否应用抗生物无关（P均＞0.05）.89例颅内感染患者治愈73例（82.02％）,显效7例（7.87％）,进步8例（8.99％）,无效1例（1.12％）.结论 神经外科手术时,可以通过采用恰当的手术方式、减少手术时间、加强引流管护理、防止脑脊液漏等方式预防和减少颅内感染的发生;合理治疗可以有效治疗颅内感染.

Risk factors and clinical analysis of intracranial infection after craniotomy

Objective To investigate pathogenic factors,prevention approaches and therapeutic methods of neurosurgical postoperative intracranial infection.Methods A total of 89 cases were selected as our subjects from 1432 cases ho had received neurosurgical operation in the First People＇s Hospital of Shangqiu from April 2009 to April 2012.The clinical data of 89 cases with intracranial infection were retrospectively analyzed.Chisquare test was selected to analyze the factors which might cause infection.Effect of decision criteria was chosen to evaluate the cure effect.Results The infection rate was related to the approach to the post fossa,operation periods above 4 h,ventricular drainage,long indwelling drainage and cerebrospinal fluid （CSF） leakage （P ＜0.05 or P ＜0.01）.However,the infection rate was not related to age,sex and application of antibiotics before the operation （P ＞0.05）.As to effects,73 cases （82.02％） were cured,and 7 cases （7.87％） were showed sort of effects,as well as 8 cases（8.99％） were improved a little and 1 case（1.12％） with invalid.Conclusion It is important to adopt appropriate operation method,by decreasing operation time,preventing drainage from pollution carefully in order to prevent and decrease the intracranial infection after craniotomy,prevention CSF leakage and proper treatment could effectively cure intracranial infection.