颅脑损伤术后并发脑脓肿相关因素分析

Retrospective analysis of related factors and prevention of brain abscesses after surgery for craniocerebral injury

目的探讨颅脑损伤术后并发脑脓肿的相关因素。方法收集颅脑损伤术后发生脑脓肿26例临床资料进行回顾性分析,分别从医源性因素和非医源性因素两方面进行研究。结果颅脑损伤术后发生脑脓肿与非医源性因素中的年龄、术前GCS评分、开放性伤口、合并有基础病,以及与医源性因素中的手术时间(>4 h)、短期内二次或二次以上手术和脑脊液切口漏等因素有相关性(P<0.05);与性别、脑脊液耳鼻漏、引流管留置时间和气管切开等因素无相关性。结论及早采取措施对高危因素进行干预,加强围术期处理,有助于降低颅脑损伤术后脑脓肿的发生。

Objective To study the related factors and the prevention of brain abscess after surgery for craniocerebral injury. Methods 26 patients with brain abscess from 278 patients with intracraniat infection after surgery for craniocerebral injury were recruited. Clinical data of these patients were retrospectively analyzed, separately from non-iatrogenic factors and iatrogenic factors. Results Brain abscesses after surgery for craniocerebral injury was associated with the iatrogenie factors： age,preoperative GCS score, open wounds, and combination with basic disease; and with the iatrogenic factors： surgery time （ 〉4 h） , second surgery or more times in short term and CSF incision leakage （ P 〈 0.05 ）. The correlation of brain abscesses after surgery for craniocerebral injury with gender, eerebrospinal fluid leak, drainage tube indwelling time and incision of trachea had no statistical significanct differene. Conclusions Early interference for high-risk factors and reinforcement of perioperative management conduces to reducing the occurenee of postoperative brain abscesses after craniocerebral injury.