开颅手术后颅内感染相关危险因素的Logistic回归分析

目的探讨开颅手术后颅内感染相关的危险因素，为预防和控制颅内感染提供依据。方法检索1994年至2004年在国内杂志发表的有关颅内感染的相关文献，收集描述其相关危险因素的文献进行荟萃分析，对开颅术后颅内感染的相关危险因素进行二分类Logistic回归统计。结果共有46篇论文进入荟萃分析，其中有18篇文献探讨了颅内感染危险因素构成比，12篇可提取6种主要相关危险因素的可比较资料。开颅术后发生颅内感染构成比最高的是手术时间〉4h，占54．81％，其它依次为颅内置管引流、后颅窝手术、开放性颅脑损伤、急诊手术和脑脊液漏。二分类Logistic回归统计结果显示，脑脊液漏（OR=11．587）、开放性颅脑损伤（OR=3．024）和后颅窝手术（OR=2．737）是构成颅内感染密切关联危险因素（P〈0．05，OR〉1）。结论分析结果证实了开颅手术后脑脊液漏、开放性颅脑损伤和后颅窝手术是术后颅内感染的主要危险因素。

Logistic Regression for Risk Factors Related to Intracranial Infection after Craniotomy

Objective To provide the basis for preventing and controlling intracranial infection after the craniotomy. Methods All the articles relevant to the intracranial infection after the craniotomy which were published at home from 1994 to 2004 were looked up and the risk factors related to the intracranial infection after the craniotomy were analysed by logistic regression. Results Forty-six articles were selected for meta-analysis. The data related to the constituent ratio of the risk factors of the intracranial infection after the craniotomy were extracted from 18 articles. Seven kinds of the risk factors related the intracranial infection after the craniotomy which were comparable with each other were extracted from 12 articles. The highest constituent ratio of the intracranial infection after the craniotomy was the operation that lasted more than four hours （54.81%）. The others risk factors were cerebrospinal fluid drainage, posterior fossa operation, open craniocerebral injury, emergency operation and cerebrospinal fluid leakage in order of the constituent ratio. The cerebrospinal fluid leakage, open craniocerebral injury and posterior fossa operation were the risk factors closely related to the intracranial infection after the craniotomy （P〈0.05, OR〉1）. ORs of cerebrospinal fluid leakage, open craniocerebral injury and posterior fossa operation were 11.587, 3.024 and 2.737 respectively. Conclusions The most main risk factors of the intracranial infection after the craniotomy are cerebrospinal fluid leakage, open craniocerebral injury and posterior fossa operation.