重型颅脑损伤开颅术后发生颅内感染的影响因素研究

目的探讨重型颅脑损伤开颅术后发生颅内感染的影响因素。方法回顾性分析2016年1月至2019年12月我院收治的60例重型颅脑损伤患者的临床资料,根据术后颅内感染发生情况分为感染组(n=22)和未感染组(n=38)。分析重型颅脑损伤开颅术后发生颅内感染的影响因素。结果感染组的手术次数、手术时间、术前GCS评分、引流管留置时间、切口脑脊液漏占比均高于未感染组,术后ALB水平低于未感染组(P <0.05);Logistic多因素分析显示,手术次数≥2次、手术时间≥3 h、术前GCS评分≥8分、引流管留置时间≥48 h、术后ALB<35 g/L、存在切口脑脊液漏是重型颅脑损伤开颅术后发生颅内感染的危险因素(OR>1, P <0.05)。结论手术次数≥2次、手术时间≥3 h、术前GCS评分≥8分、引流管留置时间≥48 h、术后ALB<35 g/L、存在切口脑脊液漏是重型颅脑损伤开颅术后发生颅内感染的危险因素,需采取有效的措施进行预防。

Study on the Influencing Factors of Occurrence of Intracranial Infection After Craniotomy for Severe Craniocerebral Injury

Objective To explore the influencing factors of occurrence of intracranial infection after craniotomy for severe craniocerebral injury.Methods The clinical data of 60 patients with severe craniocerebral injury admitted to our hospital from January 2016 to December 2019 were retrospectively analyzed.According to the occurrence of postoperative intracranial infection,all cases were divided into infected group(n=22)and uninfected group(n=38).The influencing factors of occurrence of intracranial infection after craniotomy for severe craniocerebral injury were analyzed.Results The surgery times,operation time,preoperative GCS score,drainage tube indwelling time and proportion of incisional cerebrospinal fluid leakage of infected group were higher than those of uninfected group,and the postoperative ALB level was lower than that of uninfected group(P<0.05).Logistic multivariate analysis showed that the surgery times≥2 times,operation time≥3 h,preoperative GCS score≥8 points,drainage tube indwelling time≥48 h,postoperative ALB<35 g/L,and the presence of incisional cerebrospinal fluid leakage were the risk factors for occurrence of intracranial infection after craniotomy for severe craniocerebral injury(OR>1,P<0.05).Conclusions Surgery times≥2 times,operation time≥3 h,preoperative GCS score≥8 points,drainage tube indwelling time≥48 h,postoperative ALB<35 g/L,and the presence of incisional cerebrospinal fluid leakage are the risk factors for occurrence of intracranial infection after craniotomy for severe craniocerebral injury,and effective measures should be taken for prevention.