颅脑手术后颅内感染易感因素与耐药性分析

Intracranial Infection after Craniotomy Susceptibility Factor Analysis and Analysis of Antibiotic Resistance

目的:探讨开颅手术后颅内感染易感因素及耐药性。方法:回顾我科1114例颅脑手术后39例颅内感染患者的有关临床资料。结果:开放性颅脑损伤手术13例(33.3%),闭合性颅脑损伤手术5例(12.8%),高血压脑出血血肿清除术5例(12.8%),幕上颅内肿瘤切除术3例(7.7%),幕下颅内肿瘤切除术4例(10.4%),脑室腹腔分流术5例(12.8%),脑脓肿摘除术2例(5.1%),颅骨修补术2例(5.1%)。术后留置引流管26例,脑脊液切口漏12例,切口下积液9例,脑室外引流3例,手术时间>4小时23例。结论:颅内感染的发生与多种因素有关,诸如:脑脊液耳鼻和切口漏、术中所置引流管和脑室外引流管、手术时间过长、激素的术前应用的等有关。致病菌以肺炎双球菌、嗜血流感杆菌、金黄色葡萄球菌居多,大多数对头孢唑林、头孢曲松、青霉素耐药。

Objective：Discussion post-craniotomy intracranial infection risk factors and drug resistance.Methods：114 cases of I-1 after 39 cases of brain surgery in patients with intracranial infection of clinical data.Results：Open surgery 13 cases of traumatic brain injury（33.3%）,closed head injury surgery in 5 cases（12.8%）,hypertensive intracerebrat hemorrhage hematoma in 5 cases（12.8 %）,supratentorial intracranial tumors in 3 cases（7.7%）,supratentorial brain tumor resection under the four cases（10.4%）,ventriculop eritoneal shunt in 5 cases（12.8%）,brain abscess surgery two cases（5.1%）,two cases of cranioplasty（5.1%）.After 26 cases of catheter drainage,12 cases of cerebrospinal fluid leakage incision,incision nine cases of effusion,3 cases of ventricular drainage,operative time〉4 hours in 23 eases.Conclusion：Incidence of intracranial infection with a variety of factors,such as：ear,nose and incision leakage of cerebrospinal fluid,patients in the home and ventricular drainage tube drainage tube,surgical time,preoperative hormone and other related applications.Streptococcus pneumoniae bacteria,Haemophilus influenzae bacteria,Staphylococcus aureus was most likely majority of ce fazolin,ceftriaxone,penicillin-resistant.