神经外科术后颅内感染及其治疗

Post-operation intracranical infection and it's treatment in neurosurgery department.

目的探讨神经外科术后颅内感染的危险因素及其治疗方法。方法以４４６３例颅脑手术后发生颅内感染的１１８例为研究对象，对开颅手术后颅脑感染发病时机、发生颅内感染的危险因素及治疗结果等临床资料进行统计分析。结果本组９４９％术后３～７天起病，多种危险因素可能导致术后颅内感染，第三代头孢类抗生素头孢他啶有良好的治疗效果，优于青霉素合并丁胺卡那治疗组（χ２＝２４６，Ｐ＜００１），鞘内注射头孢他啶有助于治疗难治性、严重的颅内感染。结论预防术后颅内感染危险因素。

Objective To study the risk factors inducing post-operation and intracranial infection and its therapy. Methods Among 4463 in-patients who had been performed on brain operation, the data of 118 cases with intracranical infection were analyzed, including the onset time of infection, risk factors, treatment and so on. Results 94.4% of intracranial infection cases induced by many risk factors occurred from three to seven days after the operation. The research found that ceftazidime a third gereration cephalosporin had more satisfactory treatment effect than the one of penicillin and amikacin (χ2=24.6, P<0.01) and that ceftazidime intrathecally injected also has a better treatment result in severe intracranial infection. Conclusions Decreasing risk factors of post-operation intracranial infection using suitable antibiotics and intrathecally injecting ceftazidime could improve the surrival rate of the patients.