开颅术后颅内压监测下继发颅内感染的危险因素及防治措施

目的探讨开颅术后颅内感染发生的易感因素及防治措施。 方法选取自2010年8月至2014年8月凉山彝族自治州第一人民医院神经外科收治的颅脑术后发生颅内感染的21例患者的临床资料进行分析，采用t检验和logistic回归分析方法研究各因素与颅内感染的关系。 结果单因素分析结果显示，颅内感染的发生与年龄（≥70岁）、术前GCS评分（≤8分）、是否合并糖尿病、手术时间（>4 h）、颅内压监测天数（>7 d）等因素有相关性，差异具有统计学意义（P<0.05）；进一步通过多因素logistic回归分析发现，年龄（≥70岁）、术前GCS评分（≤8分）、手术时间（>4 h）、颅内压监测天数（>7 d）是颅脑手术颅内压监测下继发颅内感染的独立危险因素。 结论加强老年患者的营养支持，尽量缩短手术时间，尽早拔除颅内压传感器，严格无菌操作，是有效预防颅内感染的重要措施。

Clinical analysis of secondary intracranial infection after intracranial pressure monitoring in craniocerebral operation

ObjectiveTo explore the susceptible factors and prevention of occurrence ofintracranial infection after craniotomy. MethodsFrom 2010 August to 2014 August, the craniocerebral operation was performed in 143 patients, the clinical data including 21 cases of intracranial infection patients were analyzed. t test and logistic regression were used to analyze the relationship between the factors and intracranial infection. ResultsSingle factor analysis showed that the incidence of postoperative infections was related to advanced age of patients, preoperative GCS, combined with diabetes mellitus, long-time operation (> 4 h), and intracranial pressure monitoring days (P<0.05). Multivariate logistic regression analysis showed that advanced age of patients, preoperative GCS, long-time operation (>4 h), and intracranial pressure monitoring days were independent factors for secondary intracranial infection after intracranial pressure monitoring in craniocerebral operation. ConclusionThe intracranial infection can be effectively controlled by strengthening nutrition support among elderly patients, shortening the operation time, early removing intracranial pressure sensor, strengthening antibiotic management in peri operation period, and strict aseptic operation.