神经外科开颅手术后神经系统感染的原因分析

目的分析影响开颅手术术后并发神经系统感染的风险因素。方法回顾性分析2008—01--2012-01在我院接受开颅手术患者的临床资料。计算开颅手术后发生神经系统感染的发生率以及开颅手术后神经系统感染的影响因素（手术时间、脑脊液漏、糖尿病、侧脑室引流、置管、术前使用激素、术前使用抗菌药）。结果老年患者开颅术后神经系统感染率为4．79％。手术时间〉5h的患者感染率显著高于手术时间≤5h的患者，差异具有统计学意义（7．25％VS2．60％，X^2=5．169，P=0．023）；脑脊液漏患者感染率显著高于无脑脊液漏患者，差异有统计学意义（55．00％VS2．39％，X^2=115．700，P〈0．001）；合并糖尿病患者感染率显著高于无糖尿病患者，差异有统计学意义（20．29％VS1．90％，X^2=43．080，P〈0．001）；行侧脑室引流患者感染率显著高于未行侧脑室引流患者，差异有统计学意义（40．00％VS2．21％，X^2=87．450，P〈0．001）。结论老年患者开颅术后神经系统感染率为4．79％。手术时间〉5h、脑脊液漏、侧脑室引流及合并糖尿病是导致开颅手术后神经系统感染的独立危险因素。

Analysis on the cause of nervous system infection after craniotomy surgery

Objective To analysis the cause o nervous system infection after craniotomy surgery. Methods Methods Clinical data of patients received craniotomy surgery at our hospital from 2008 to 2012 was retrospectively analyzed. Results A total of 438 patients were retrospectively analyzed. The infection rate was 4.79%. Logistic regression analysis found that the time of operation~5 h, leakage of cerebrospinal fluid, paraventriculostomy and glycuresis were independent risk factors for nervous system infection after craniotomy surgery（P~0.05）. Conclusion There is 4.79% rate of infection after craniotomy surgery and the time of operation〉5 h,leakage of cerebrospinal fluid, paraventriculostomy and glycuresis are independent risk factors for nervous system infection.