神经外科Ⅰ类切口术后颅内感染的危险因素分析
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摘要
目的分析神经外科Ⅰ类切口术后发生颅内感染的危险因素。方法回顾性分析2017年1月—12月我院986例行神经外科Ⅰ类切口开颅手术患者的临床资料。根据术后是否发生颅内感染将分为感染组和未感染组,比较2组一般资料,分析神经外科Ⅰ类切口开颅手术患者术后并发颅内感染的危险因素。结果 986例行神经外科Ⅰ类切口开颅手术患者术后发生颅内感染者27例(2. 74%)。年龄≥60岁、术前合并糖尿病、手术时间≥4 h、术后留置引流管、术后脑脊液漏是影响神经外科Ⅰ类切口开颅手术患者术后颅内感染发生的独立危险因素(P <0. 05)。结论神经外科Ⅰ类切口开颅手术患者年龄≥60岁、术前合并糖尿病、手术时间≥4 h、术后留置引流管、术后脑脊液漏是导致其术后颅内感染发生的独立危险因素。
Objective To analyze risk factors for intracranial infection in patients with type I incision after neurosurgery surgery. Methods Clinical data of 986 patients with type I incision undergoing craniotomy from January to December 2017 was retrospectively analyzed. The incidence rate of postoperative intracranial infection was statistically analyzed,and the patients were divided into infected group and uninfected group according to whether or not having intracranial infection after operation. In two groups,general data was compared,and risk factors for intracranial infection in patients with type I incision after craniotomy in neurosurgery department were analyzed. Results There were 27 patients( 2. 74%) with intracranial infection after operation among 986 patients with type I incision after craniotomy in neurosurgery department. Age equal or more than 60 years old,combined with diabetesmellitus before operation,operative time equal or more than 4 h,postoperative indwelling drainage tube and postoperative cerebrospinal fluid leakage were independently risk factors for intracranial infection in patients with type I incision after neurosurgery surgery( P < 0. 05).Conclusion Age equal or more than 60 years old,combined with diabetesmellitus before operation,operative time equal or more than 4 h,postoperative indwelling drainage tube and postoperative cerebrospinal fluid leakage are independently risk factors for intracranial infection in patients with type I incision after neurosurgery surgery.
Objective To analyze risk factors for intracranial infection in patients with type I incision after neurosurgery surgery. Methods Clinical data of 986 patients with type I incision undergoing craniotomy from January to December 2017 was retrospectively analyzed. The incidence rate of postoperative intracranial infection was statistically analyzed,and the patients were divided into infected group and uninfected group according to whether or not having intracranial infection after operation. In two groups,general data was compared,and risk factors for intracranial infection in patients with type I incision after craniotomy in neurosurgery department were analyzed. Results There were 27 patients( 2. 74%) with intracranial infection after operation among 986 patients with type I incision after craniotomy in neurosurgery department. Age equal or more than 60 years old,combined with diabetesmellitus before operation,operative time equal or more than 4 h,postoperative indwelling drainage tube and postoperative cerebrospinal fluid leakage were independently risk factors for intracranial infection in patients with type I incision after neurosurgery surgery( P < 0. 05).Conclusion Age equal or more than 60 years old,combined with diabetesmellitus before operation,operative time equal or more than 4 h,postoperative indwelling drainage tube and postoperative cerebrospinal fluid leakage are independently risk factors for intracranial infection in patients with type I incision after neurosurgery surgery.
引文
[1]韩书清.万古霉素静脉及鞘内联合用药治疗开颅手术后颅内感染的临床观察[J].解放军预防医学杂志,2016,34(S1):150.
[2]徐廷伟,敖祥生,秦永芳,等.神经外科患者术后颅内感染危险因素分析[J].中华医院感染学杂志,2016,26(8):1758-1760.
[3] Jiang L,Guo L,Li R,et al. Targeted surveillance and infection-related risk factors of nosocomial infection in patients after neurosurgical operation[J]. Pak J Pharm Sci,2017,30(3):1053-1056.
[4]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[5]李冬,姜君君.神经外科颅内感染患者脑脊液病原菌分布及耐药特点[J].中国临床药学杂志,2016,25(5):295-299.
[6]李恒爱,刘大钺,卢建军,等.神经外科Ⅰ类切口术后感染影响因素分析[J].中华医院感染学杂志,2017,27(17):3940-3943.
[7]谭博,刘绍明.神经外科术后颅内感染危险因素分析研究[J].中华神经外科疾病研究杂志,2015,14(3):283-285.
[8]林秀娟,阮建锋,林红燕,等.神经外科患者术后颅内感染易感因素分析[J].中华医院感染学杂志,2015,25(5):1133-1135.
[9]任晓辉,张扬,高之宪,等.神经外科术后颅内感染的影响因素及风险预测分析[J].中华神经外科杂志,2015,31(10):992-996.
[10]朱东,鲁丽利,张剑丰,等.糖尿病患者免疫功能改变与预防肺部感染的临床研究[J].中华医院感染学杂志,2015,25(8):1790-1792.
[11]邢永国,孟伟英,张淑祥,等.神经外科开颅术后颅内感染诊治新进展[J].中华医院感染学杂志,2016,26(22):5268-5271.
[12] Cassir N,De La Rosa S,Melot A,et al. Risk factors for surgical site infections after neurosurgery:A focus on the postoperative period[J]. Am J Infect Control,2015,43(12):1288-1291.
[13]徐明,史中华,陈光强,等新.小儿神经外科幕上手术后颅内感染的发生率及危险因素调查[J].首都医科大学学报,2015,36(3):454-458.
[14] Fang C,Zhu T,Zhang P,et al. Risk factors of neurosurgical site infection after craniotomy:A systematic review and meta-analysis[J]. Am J Infect Control,2017,45(11):e123-e134.
[15]张扬,季楠,高之宪,等.预防性应用抗生素时限对神经外科Ⅰ类切口术后颅内感染影响的随机对照研究[J].中华神经外科杂志,2017,33(10):1017-1020.
[16]张文学,方树民.神经外科患者术后颅内感染病原菌分布及相关因素分析[J].中国病原生物学杂志,2016,11(11):1035-1038.
[17]华春华,朱道平,李奕秋,等.重型脑交通伤患者的预后相关因素分析[J].中国煤炭工业医学杂志,2013,16(7):1085-1088.
[18]张美彪,王列,罗科辉,等.开颅患者术后颅内感染相关因素分析与干预措施[J].中华医院感染学杂志,2016,26(3):589-590,596.
[19]曾海燕,方治强,严亿军.回顾性分析颅脑手术后颅内感染的危险因素[J].国际神经病学神经外科学杂志,2015,42(5):429-431.
[20] Kourbeti I S,Vakis A F,Ziakas P,et al. Infections in patients undergoing craniotomy:risk factors associated with post-craniotomy meningitis[J]. J Neurosurg,2015,122(5):1113-1119.
[21] Kim J S,Park I S,Kim S K,et al. Analysis of the Risk Factors Affecting the Surgical Site Infection after Cranioplasty Following Decompressive Craniectomy[J]. Korean J Neurotrauma,2015,11(2):100-105.
[22]张松坡,高玉松,胡承啸,等.神经外科手术后颅内感染患者病原菌分布及其影响因素研究[J].实用心脑肺血管病杂志,2016,24(1):29-32.
[23]岳晓艳,石广志.神经外科术后颅内感染患者的抗生素使用[J].首都医科大学学报,2013,34(2):177-180.
[24]李建华,吴以艺,任振超.颅脑损伤伴发颅内感染患者的临床特点和急性预后的相关因素分析[J].中国当代医药,2016,23(21):54-56,59.
[25]李明,王斌,吴中华,等.腰大池引流术治疗未拔除脑室腹腔分流管的颅内感染七例报道及文献回顾[J].中华神经医学杂志,2016,15(6):621-624.
[26]黄燕群,叶建丽,黄燕萍.综合护理对颅脑术后颅内感染发生率、死亡率及预后的影响分析[J].中国实用医药,2018,13(16):149-151.
[2]徐廷伟,敖祥生,秦永芳,等.神经外科患者术后颅内感染危险因素分析[J].中华医院感染学杂志,2016,26(8):1758-1760.
[3] Jiang L,Guo L,Li R,et al. Targeted surveillance and infection-related risk factors of nosocomial infection in patients after neurosurgical operation[J]. Pak J Pharm Sci,2017,30(3):1053-1056.
[4]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[5]李冬,姜君君.神经外科颅内感染患者脑脊液病原菌分布及耐药特点[J].中国临床药学杂志,2016,25(5):295-299.
[6]李恒爱,刘大钺,卢建军,等.神经外科Ⅰ类切口术后感染影响因素分析[J].中华医院感染学杂志,2017,27(17):3940-3943.
[7]谭博,刘绍明.神经外科术后颅内感染危险因素分析研究[J].中华神经外科疾病研究杂志,2015,14(3):283-285.
[8]林秀娟,阮建锋,林红燕,等.神经外科患者术后颅内感染易感因素分析[J].中华医院感染学杂志,2015,25(5):1133-1135.
[9]任晓辉,张扬,高之宪,等.神经外科术后颅内感染的影响因素及风险预测分析[J].中华神经外科杂志,2015,31(10):992-996.
[10]朱东,鲁丽利,张剑丰,等.糖尿病患者免疫功能改变与预防肺部感染的临床研究[J].中华医院感染学杂志,2015,25(8):1790-1792.
[11]邢永国,孟伟英,张淑祥,等.神经外科开颅术后颅内感染诊治新进展[J].中华医院感染学杂志,2016,26(22):5268-5271.
[12] Cassir N,De La Rosa S,Melot A,et al. Risk factors for surgical site infections after neurosurgery:A focus on the postoperative period[J]. Am J Infect Control,2015,43(12):1288-1291.
[13]徐明,史中华,陈光强,等新.小儿神经外科幕上手术后颅内感染的发生率及危险因素调查[J].首都医科大学学报,2015,36(3):454-458.
[14] Fang C,Zhu T,Zhang P,et al. Risk factors of neurosurgical site infection after craniotomy:A systematic review and meta-analysis[J]. Am J Infect Control,2017,45(11):e123-e134.
[15]张扬,季楠,高之宪,等.预防性应用抗生素时限对神经外科Ⅰ类切口术后颅内感染影响的随机对照研究[J].中华神经外科杂志,2017,33(10):1017-1020.
[16]张文学,方树民.神经外科患者术后颅内感染病原菌分布及相关因素分析[J].中国病原生物学杂志,2016,11(11):1035-1038.
[17]华春华,朱道平,李奕秋,等.重型脑交通伤患者的预后相关因素分析[J].中国煤炭工业医学杂志,2013,16(7):1085-1088.
[18]张美彪,王列,罗科辉,等.开颅患者术后颅内感染相关因素分析与干预措施[J].中华医院感染学杂志,2016,26(3):589-590,596.
[19]曾海燕,方治强,严亿军.回顾性分析颅脑手术后颅内感染的危险因素[J].国际神经病学神经外科学杂志,2015,42(5):429-431.
[20] Kourbeti I S,Vakis A F,Ziakas P,et al. Infections in patients undergoing craniotomy:risk factors associated with post-craniotomy meningitis[J]. J Neurosurg,2015,122(5):1113-1119.
[21] Kim J S,Park I S,Kim S K,et al. Analysis of the Risk Factors Affecting the Surgical Site Infection after Cranioplasty Following Decompressive Craniectomy[J]. Korean J Neurotrauma,2015,11(2):100-105.
[22]张松坡,高玉松,胡承啸,等.神经外科手术后颅内感染患者病原菌分布及其影响因素研究[J].实用心脑肺血管病杂志,2016,24(1):29-32.
[23]岳晓艳,石广志.神经外科术后颅内感染患者的抗生素使用[J].首都医科大学学报,2013,34(2):177-180.
[24]李建华,吴以艺,任振超.颅脑损伤伴发颅内感染患者的临床特点和急性预后的相关因素分析[J].中国当代医药,2016,23(21):54-56,59.
[25]李明,王斌,吴中华,等.腰大池引流术治疗未拔除脑室腹腔分流管的颅内感染七例报道及文献回顾[J].中华神经医学杂志,2016,15(6):621-624.
[26]黄燕群,叶建丽,黄燕萍.综合护理对颅脑术后颅内感染发生率、死亡率及预后的影响分析[J].中国实用医药,2018,13(16):149-151.
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