微创穿刺治疗高血压脑出血术后颅内感染的临床特点及预防对策

Clinical characteristics of postoperative intracranial infections in hypertensive cerebral hemorrhage patients undergoing minimally invasive surgery

目的分析微创穿刺治疗高血压脑出血术后颅内感染的临床特点,探讨可行的预防对策,降低颅内感染的发生率。方法对2005-2012年采用微创穿刺治疗的412例高血压脑出血患者临床资料进行统计分析,对感染与未感染患者治疗过程中的差异和患者自身的差异进行比较,数据采用采用SPSS15.0软件进行统计。结果 412例高血压脑出血患者经过微创穿刺治疗后发生颅内感染23例,感染率为5.58%,病原菌以金黄色葡萄球菌为主达39.13%;多针穿刺的感染率为9.29%,高于单针穿刺患者的1.08%;23例发生颅内感染的患者平均引流时间为(7.8±4.6)d,389例未感染患者平均引流时间为(5.2±3.4)d。结论血肿清除量、患者病情严重程度、引流时间等是影响高血压脑出血患者微创穿刺治疗后发生颅内感染的重要因素,有效的预防对策是降低颅内感染发生的关键。

OBJECTIVE To analyze the clinical characteristics of postoperative intracranial infections in the hypertensive cerebral hemorrhage patients undergoing minimally invasive surgery.METHODS The clinical data of 412 hypertensive cerebral hemorrhage patients who underwent the minimally invasive surgery from 2005 to 2012were statistically analyzed,then the treatment process and the patients own condition were compared between the patients with infections and the patients without infections,and the statistical analysis of data was performed with the use of SPSS15.0 software.RESULTS After the minimally invasive surgery,the intracranial infections occurred in 23 of 412hypertensive cerebral hemorrhage patients with the infection rate of 5.58%.The Staphylococcus aureus was the predominant species of pathogen,accounting for 39.13%.The incidence of intracranial infections was 9.29% in the patients undergoing multi-needle aspiration,higher than 1.08% in the patients undergoing single needle aspiration.The mean drainage duration of the 23 patients with intracranial infections was（7.8±4.6）days,the 389 patients without infections（5.2±3.4）days.CONCLUSION The volume of hematoma clearance,severity of illness condition,and drainage duration are the predisposing factors for the intracranial infections in the hypertensive cerebral hemorrhage patients after the minimally invasive surgery,and the effective prevention countermeasures may contribute to the reduction of incidence of intracranial infections.