开颅术后颅内感染的相关危险因素分析

Related risk factors for intracranial infeion after craniotomy

目的探讨开颅术后颅内感染的相关危险因素,为临床预防和控制颅内感染提供依据。方法 46例接受开颅手术患者根据是否颅内感染分为感染组(16例)和未感染组(30例),对2组患者的临床资料进行回顾性分析。结果单因素分析结果显示,开颅术后颅内感染与手术距发病时间、住院时间、手术入路方式、手术持续时间及手术者职称(技术水平)有关(P<0.05),而与年龄、性别、基础疾病、入院诊断、颅脑手术次数等因素无相关性(P>0.05)。Logistic回归分析显示,手术持续时间>3 h、手术者职称(技术水平)及手术入路方式是颅脑手术后发生颅内感染的独立危险因素(P<0.05)。结论手术持续时间、手术者的职称(技术水平)和手术入路方式是开颅手术后发生颅内感染的高危险因素;提高手术者技术水平、缩短手术时间和选择恰当的手术入路是减少开颅术后颅内感染的关键。

Objective To investigate the risk factors related to the intracranial infection after craniotomy and provide reference for the clinical prevention and control of intracranial infection.Methods Forty-six patients with craniotomy were divided into infection group（n=16）and non-infection group（n=30）according to whether intracranial infection,then the clinical data of the patients were analyzed retrospectively.Results Univariate analysis results showed that the time of operation to onset,hospitalization time,operative approach,operation time and the technical level of operators were related to the intracranial infection after craniotomy（P0.05）;but the age,sex,basic disease,admitting diagnosis and craniocerebral operations times were not related to the intracranial infection after craniotomy（P0.05）.Logistic regression analysis showed that the operation time exceed 3 hours,technical level of operators and operative approach were the independent risk factors for intracranial infection after craniotomy（P0.05）.Conclusion The operation time,technical level of operators and operative approach are the high risk factors for intracranial infection after craniotomy.The key to reduce the intracranial infection after craniotomy is improving the technical level of operators,shortened the operation time and choosing the correct operative approach.