脑室出血术后并发颅内感染相关危险因素研究

目的 探讨脑室出血术后并发颅内感染(VAI)的危险因素,为其预防提供参考。 方法 回顾性分析2013年8月-2016年8月在金华市中心医院神经外科收治的脑室出血术后患者的资料,通过临床表现和实验室检查诊断颅内感染。采用Logistic回归分析脑室出血术后并发颅内感染的危险因素。 结果 共纳入符合标准的脑室出血术后患者276例,其中男性184例(66.7%),女性92例(33.3%);年龄32~79岁,平均(65.9±8.1)岁。根据术后是否发生颅内感染,将患者分为VAI组和非VAI组,其中VAI组31例(11.2%),非VAI组245例(88.8%)。Logistic多因素回归分析显示,双侧脑室引流(OR=1.213,95% CI:1.003~1.632,P=0.023)、皮下隧道<5 cm(OR=1.821,95% CI:1.554~2.232,P<0.001)和引流管留置>7 d(OR=2.658,95% CI:1.813~3.223,P<0.001)是VAI的独立危险因素。 结论 脑室出血术后并发颅内感染是脑室出血术后常见的并发症,双侧脑室引流、皮下隧道<5 cm和引流管留置>7 d是脑室出血术后并发颅内感染的独立危险因素,对此类患者应重点监护。 

Risk factors associated with intracranial infection after surgery for intraventricular hemorrhage

Objective To investigate the risk factors associated with ventriculostomy-associated infections (VAI) after intraventricular hemorrhage (IVH) and provide basis for the prevention of intracranial infection. Methods The clinical data of patients with intracranial infection after surgery for intraventricular hemorrhage in our hospital from August, 2013 to August, 2016 were reviewed retrospectively. Logistic regression analysis was used to evaluate possible risk factors associated with VAI after IVH. Diagnosis of intracranial infection was confirmed by clinical manifestations and laboratory tests. Results Total 276 patients were enrolled in the study, including 184 male (66.7%) and 92 female (33.3%), ranged from 32 to 79 years with an average age of (65.9±8.1) years. According to the postoperative intracranial infection, the patients were divided into VAI group (31 cases, 11.2%) and non-VAI group (245 cases, 88.8%). Multivariate Logistic regression analysis showed that bilateral ventricular drainage (OR=1.213, 95% CI:1.003-1.632, P=0.023), subcutaneous tunnel length<5 cm (OR=1.821, 95% CI:1.554-2.232, P<0.001) and duration of ventricular drainage>7 d (OR=2.658, 95% CI:1.813-3.223, P<0.001) were the independent risk factors of VAI. Conclusion VAI is a common complication after intraventricular hemorrhage. Bilateral ventricular drainage, subcutaneous tunnel length<5 cm, duration of ventricular drainage>7 d are the independent risk factors of VAI in patients after intraventricular hemorrhage. We should pay more attentions to these patients.