神经外科开颅手术后颅内感染危险因素研究

The study of risk factors for post-craniotomy intracranial infection in patients in department of neurosurgery

目的研究神经外科开颅手术后颅内感染的危险因素，为预防提供依据。方法对神经外科开颅手术后的432例患者进行前瞻性调查。结果432例患者中，发生颅内感染67例，感染率为15．51％。留置引流管者颅内感染率为17．05％，较未引流者颅内感染率2．22％之差异有显著性（P〈0．05）；手术时间≤4h者颅内感染率为6．90％，〉4h者颅内感染率为21．32％，两者差异有显著性（P〈0．01）。脑室引流的患者颅内感染率为24．30％，其他部位引流患者颅内感染率为3．68％，两者差异有高度显著性（P〈0．001）。引流管留置1～2d感染率为10．53％，3～4d为30．34％，≥5d为68．97％，三者间差异有高度显著性（P〈0．001）。结论开颅手术后颅内感染与手术持续时间和留置引流管，特别是脑室留置引流管有关。

Objective To study the risk factors for post-craniotomy intracranial infection in patients in department of neurosurgery, so as to provide reference for prevention. Methods Four hundred and thirty-two patients with craniotomy in department of neurosurgery were investigated prospectively. Results Sixty-seven of 432 patients developed intracranial infection, the infection rate was 15.51%. The intracranial infection rate in patients with drainage was 17.05 %, which was obviously higher than that （2.22%） in patients without drainage （ P 〈 0.05）. The intracranial infection rate in patients whose duration of operation 44 h was 6.90%, which was obviously lower than that （21.32%） in patients whose duration of operation 〉4 h （ P 〈0. 001）. The intracranial infection rate in patients with ventricular drainage was 24.30%, which was obviously higher than that （3.68%） in patients with other sites drainage （ P 〈 0.01）. The intracranial infection rate in patients whose duration of drainage 1 - 2 d, 3 - 4 d and ≥5 d was 10.53%, 30.34% and 68.97% respectively （ P 〈 0. 001）. Conclusion Post-craniotomy intracranial infection is related with duration of operation and drainage, especially ventricular drainage.