神经外科术后中枢神经系统感染45例的临床分析

Clinical analysis of 45 cases of intracranial infection after neurosurgery

目的分析复旦大学附属华山医院神经外科2005 2009年中枢神经系统术后感染患者的易感因素和病原学分布。方法查阅该院自2005—2009年符合病例脑脊液培养阳性结果病例45例,回顾分析相关病史资料。结果神经外科术后中枢系统感染诱发因素中,脑外伤15例,占33.3%;自发出血8例,占17.8%;脑室打开7例,占15.6%。共分离出57株细菌,其中革兰阳性球菌19株,占33.3%;革兰阴性杆菌24株,占42.1%。结论神经外科术后中枢系统感染脑外伤是主要的诱发因素,病原菌以革兰阳性球菌及革兰阴性杆菌为主。

Objective To understand the pathogens of intracranial infections following neurosurgical operation by analyzing the relevant data of 45 patients in Neurosurgery, Huashan Hospital during the period from 2005 to 2009. Methods The clinical and microbiological data of 45 patients whose cerebrospinal fluid （CSF） culture was positive during the period from 2005 to 2009 were retrospectively reviewed and summarized. Results The top 3 predisposing factors of intraeranial infections after neurosur- gery were cerebral trauma （33.3%, 15/45）, spontaneous bleeding （17.8%, 8/45） and ventricle opening （15.6M, 7/45）. A total of 57 bacterial strains were isolated, 19 （33.3%） of which were gram-positive coccus and 24 （42. 1%） gram-negative bacillus. Conclusions Cerebral trauma is the major predisposing factor of intracranial infections after neurosurgery. The patho- gens of intracranial infection after neurosurgery are mainly gram-positive coccus and gram-negative bacillus in Huashan Hospital during 2005 and 2009.