| 林 浩,熊云彪,谭 赢,杨 恒,刘 汶.开颅手术引发颅内感染的危险因素及临床治疗效果分析[J].现代生物医学进展英文版,2024,(14):2767-2771. |
| 开颅手术引发颅内感染的危险因素及临床治疗效果分析 |
| Analysis of the Risk Factors and Clinical Treatment Effect of Intracranial Infection Caused by Craniotomy |
| Received:December 08, 2023 Revised:December 31, 2023 |
| DOI：10.13241/j.cnki.pmb.2024.14.032 |
| 中文关键词: 开颅术 颅内感染 危险因素 抗生素 葡萄球菌 |
| 英文关键词: Craniotomy Intracranial infection Risk factors Antibiotics Staphylococcus |
| 基金项目:贵州省省级科技计划项目（黔科合基础[2020]1Z066） |
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| 中文摘要: |
| 摘要 目的：探讨开颅手术引发颅内感染的危险因素及临床治疗效果。方法：回顾性选择2018年1月至2022年12月来我院行开颅手术的患者661例患者的病例资料，收集开颅手术患者的临床资料，确定开颅手术引发颅内感染的发生情况，使用单因素、二分类Logistic回顾分析确定开颅手术术后颅内感染的危险因素，分析颅内感染者的病原菌分布及构成比、开颅手术术后颅内感染患者的治疗效果。结果：661例开颅手术患者术后颅内感染发生率为5.75%。38例开颅手术术后颅内感染患者中，革兰阳性菌30例，占比81.58%（31/38），革兰阴性菌者8例，占比18.42%（7/38），其中占比最多的是葡萄球菌，占比78.95%（30/38）。Logistic回顾分析表明：保护因素为术前预防性应用抗生素，危险因素为手术时间≥4 h、白蛋白水平≤36 g/L、术后脑脊液漏、留置引流管、幕下手术（P<0.05）。38例患者中治愈出院者33例，5例出院时临床症状消失。所有患者出院后门诊或电话随访3~6个月，均无炎症复发。结论：开颅手术术后颅内感染发生率为5.75%，保护因素为术前预防性应用抗生素，危险因素为手术时间≥4 h、白蛋白水平≤36 g/L、术后脑脊液漏、留置引流管、幕下手术，开颅手术术后颅内感染中葡萄球菌占比最多，通过给予积极治疗，对于已确诊的开颅手术术后颅内感染患者，及早诊断并给予足量的敏感抗生素治疗疗效显著。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the risk factors of intracranial infection caused by craniotomy and the clinical therapeutic effect. Methods: The case data of 661 patients who underwent craniotomy in our hospital from January 2018 to December 2022 were retrospectively selected. Clinical data of patients undergoing craniotomy were collected to determine the occurrence of intracranial infection caused by craniotomy. The risk factors of intracranial infection after craniotomy were determined by univariate and binary Logistic retrospective analysis. To analyze the distribution and composition of pathogenic bacteria in intracranial infected patients and the therapeutic effect of intracranial infected patients after craniotomy. Results: The incidence of postoperative intracranial infection was 5.75% in 661 patients with craniotomy. Among 38 patients with intracranial infection after craniotomy, there were 30 cases of gram-positive bacteria, accounting for 81.58% (31/38), 8 cases of gram-negative bacteria, accounting for 18.42%(7/38), and staphylococcus, accounting for 78.95%(30/38), accounted for the largest proportion. The protective factors were preoperative prophylactic antibiotics, and the risk factors were operative time 4 h, albumin level 36 g/L, postoperative cerebrospinal fluid leakage, indwelling drainage tube, and infratentorial surgery(P<0.05). Among the 38 patients, 33 were cured and 5 had no clinical symptoms at discharge. All patients were followed up by outpatient or telephone for 3-6 months after discharge, and there was no recurrence of inflammation. Conclusion: After craniotomy postoperative incidence of intracranial infection is 5.75%, protective factors for preoperative prophylactic antibiotics, risk factors for operation time 4 h, albumin level 36 g/L, postoperative cerebrospinal fluid leakage, indwelling drainage tube, screen operation, craniotomy postoperative intracranial infection accounted for the most, by giving active treatment, for confirmed craniotomy postoperative intracranial patients infection, early diagnosis and give sufficient amount of sensitive antibiotics treatment. |
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