颅脑手术后发生颅内感染的危险因素探讨

目的:探讨颅脑手术后发生颅内感染(intracranialinfections,ICI)的危险因素及预防措施。方法:回顾性分析1994年1月至2002年12月我科4877例颅脑手术患者临床资料。结果:术后发生颅内感染141例,感染率2.89%。术后有脑脊液漏、刀口皮下积液及术后急症再次手术者,术后颅内感染的发生率分别为35.34%、24.60%及15.78%,明显高于平均感染率(P<0.05);有颅脑手术史者术后ICI发生率为5.10%,幕下手术后为6.40%,手术时间4～8h为4.40%,8h以上为7.09%,术前使用糖皮质激素者为4.80%。结论:术后脑脊液漏、局部皮下积液及急症再次手术是术后ICI发生的危险因素。

Study of risk factors for intracranial infections after craniotomy

Objective:To investigate the ris k factors and the methods of prevention and treat-ment of intracranial infection s(ICI)after craniotomy.Methods:Data of4877patients with neurosurgical pr ocedures in our department were retrospectively collected from January,199 4to December,2002.Re-sults:ICI were occurred in141patients and the incidence was2.89%.Incidences of ICI of patients with postoperative CSF leakage,subsequent accumulative liquid under scalp flap and those of emergency subsequent surgery after craniotomy were35.34%,24.60%and15.7 8%respectively,which were signif-icantly higher than the mean infectious rat e (P<0.05).Incidences of ICI in patients with previous cran-iotomy we re5.10%,those of the operation time lasted4-8hrs with a ICI 4.40% and those of above8hrs7.09%.Incidence of ICI in patients with a preopera tive glucocorticoid therapy was4.80%.Conclu-sion:Independent risk facto rs for ICI associated with neurosurgical procedures were postoperative CSF leak age,subsequent accumulative liquid under local scalp flap and early subsequent operation.