神经外科术后颅内感染的危险因素分析

目的分析神经外科患者颅脑术后颅内感染发生的危险因素。方法回顾性分析2012-01—2016-08新疆维吾尔自治区中医院神经外科298例手术患者的临床资料,记录患者的性别、年龄、格拉斯哥昏迷(GCS)评分、美国麻醉师协会(ASA)评分、手术类型、手术时间、手术次数、是否脑室外引流及术后是否发生脑脊液漏等,并进行统计分析。结果纳入298例患者,其中发生术后颅内感染26例,感染率8.7%。单因素分析显示,脑室外引流、GCS评分、术后脑脊液漏、手术时间、手术次数是颅脑术后引发颅内感染的相关危险因素(P0.05);多因素非条件Logistic回归分析显示,脑室外引流、GCS评分9分、术后发生脑脊液漏、手术时间4h、二次手术是神经外科颅脑术后引发颅内感染的独立危险因素(P0.05)。结论颅脑术后颅内感染的危险因素有脑室外引流、GCS评分、术后脑脊液漏、手术时间及二次手术,临床应采用综合预防措施减少颅内感染发生率。

Analysis of risk factors of postoperative intracranial infection in neurosurgery department

Objective To analyze the risk factors of intracranial infection after neurosurgical operation in neurosurgery department.Methods Clinical data of 298 cases of neurosurgery department in our hospital from Jan.2012 to Aug.2016 were recorded and analyzed statistically,such as gender,age,Glasgow coma score (GCS),American society of anesthesiologists (ASA) score,operation type,operation time,operation times,whether the external ventricular drainage and postoperative occurrence cerebrospinal fluid leakage.Results Some 26 cases of postoperative intracranial infection occurred in 298 cases,the infection rate was 8.7%.Univariate analysis showed that,external ventricular drainage,GCS score,postoperative cerebrospinal fluid leakage,operation time,the number of operations were the risk factors of intracranial infection after craniotomy (P<0.05),non conditional Logistic regression analysis showed that external ventricular drainage,GCS score less than 9 points,cerebrospinal fluid leakage after operation,operation time more than 4 hours,and the secondary operation were independent risk factors of intracranial infection after craniocerebral operation in department of neurosurgery (P<0.05).Conclusion The risk factors of intracranial infection include external ventricular drainage,GCS score,postoperative cerebrospinal fluid leakage,operation time and the secondary operation.Comprehensive preventive measures should be used to reduce the incidence of intracranial infection.