颅内肿瘤术后合并颅内感染的防治

Prevention and control of intracranial infections after brain tumorectomy

目的:探讨颅内肿瘤术后发生颅内感染的临床特点和防治措施。方法:总结2000年1月到2005年12月我科收治的326例颅内肿瘤手术患者的临床资料,其中术后发生颅内感染有13例,对其进行回顾性分析。结果:326例颅内肿瘤术后13例发生颅内感染,感染率为3.99%;颅内感染多为革兰氏阳性菌所致,对头孢三代抗生素敏感。13例颅内感染患者中4例死亡,病死率30.8%。结论:手术时间≥4h、引流管留置时间≥48h、术后脑脊液漏以及幕下手术是发生术后颅内感染的重要危险因素,而术前预防性应用抗生素可降低术后颅内感染的发生率;全身和鞘内注射联合应用敏感抗生素及时防治能够有效控制颅内感染、改善预后。

Objective： To investigate the clinical characters and treatment of intracranial infection（ICI） after brain tumorectomy. Methods： A total of 326 cases of intracranial tumorectomy were studied retrospectively, 13 cases of which developed ICI. Results： Thirteen of 326 cases had postoperative intracranial infection, the infection rate was 3.99%, 4 patients died, and the fatality rate was 30.8%. Gram - positive bacteria, which were sensitive to the third generation cephalosporins. Conclusion： Operating time beyond 4 hrs, indwelling time of drainage - tube exceed 48 hrs, postoperative CSF leakage, and infratentorial operation are risk factors of ICI, while prophylactic antibiotics can reduce intracranial infection rate. Systemic use and intrathecal injection of antibiotics can control infection and improve prognosis.