颅脑手术患者医院感染危险因素

目的探讨神经外科颅脑手术患者医院感染的危险因素，为预防控制神经外科医院感染提供依据。方法对某院神经外科2013年11月-2014年11月收治的200例颅脑手术患者进行调查，分析其医院感染危险因素。结果200例颅脑手术患者共发生医院感染81例、99例次，医院感染发病率为40.50%，例次发病率为49.50%；感染部位居前5位的依次为下呼吸道、泌尿道、颅内、血液、肠道。单因素分析结果显示，年龄≥60岁、格拉斯哥昏迷评分（GCS评分）＜15分、术中出血量≥800 mL、入住重症监护病房（ICU）、留置胃管、脑室引流、使用呼吸机、气管切开、使用H2受体阻滞剂是颅脑手术患者医院感染的重要危险因素（均P＜0.05）。多因素logistic回归分析显示，年龄≥60岁、GCS评分＜15分、入住ICU、使用H2受体阻滞剂是颅脑手术患者发生医院感染的独立危险因素。结论加强神经外科颅脑手术患者医院感染监测，了解发生医院感染的高危因素，有助于采取综合预防措施，降低颅脑手术患者医院感染发病率。

Risk factors for healthcare associated infection in patients undergoing craniocerebral operation

ObjectiveTo explore risk factors for healthcare associated infection(HAI) in patients undergoing craniocerebral operation, and provide guidance for the prevention of HAI in patients in department of neurosurgery.Methods200 patients who underwent craniocerebral operation in a department of neurosurgery from November 2013 to November 2014 were surveyed, risk factors for HAI were analyzed.ResultsAmong 200 patients undergoing craniocerebral operation, 81 patients developed 99 cases of HAI, HAI rate was 40.50%, HAI case rate was 49.50%; the top five HAI sites were lower respiratory tract, urinary tract, intracranial site, bloodstream, and intestinal tract. Univariate analysis showed that patients’ age ≥60, Glasgow Coma Scale (GCS)＜15, intraoperative blood loss ≥800 mL, staying in intensive care unit(ICU), indwelling gastric tube, ventricular drainage, using ventilator, tracheotomy, and using H2 receptor antagonists were important risk factors for HAI in patients undergoing craniocerebral operation (all P<0.05). Multivariate logistic regression analysis showed that patients’ age ≥60, GCS＜15, staying in ICU, and using H2 receptor antagonists were independent risk factors for HAI in patients undergoing craniocerebral operation.ConclusionStrengthening the surveillance of HAI patients undergoing craniocerebral operation and realizing risk factors for HAI are helpful for taking comprehensive prevention measures and reducing the incidence of HAI.