听神经鞘瘤术后颅内感染的危险因素分析

Risk factors for postoperative intracranial infections in patients undergoing acoustic neuroma resection

目的探讨听神经鞘瘤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参考。方法选取神经外科于2000年4月-2013年4月收治的312例接受听神经鞘瘤手术患者临床资料,统计术后颅内感染发生率,并根据听神经鞘瘤术后颅内感染的诊断标准对其检测指标进行分析。结果 312例手术患者中40例出现了颅内感染,感染率为12.8%;单因素分析结果显示,高龄、住院天数>20d、手术时间过长、合并糖尿病、使用激素、术后脑脊液漏、术前使用抗菌药物等与颅内感染的发生具有相关性(P<0.05);多因素logistic回归分析结果显示,患者手术持续时间、术前患有糖尿病、术后脑脊液漏、使用激素等是颅内感染的独立危险因素。结论听神经鞘瘤术后颅内感染率较高,听神经鞘瘤手术发生颅内感染的危险因素较多,其中患者手术持续时间过长、术前合并糖尿病、术后脑脊液漏、使用激素等均为颅内感染的独立危险因素。

OBJECTIVE To explore the related risk factors for intracranial infections after the acoustic neuroma re-section so as to provide basis for clinical prevention and control of the intracranial infections.METHODS The clini-cal data were collected from 3 1 2 patients who received the acoustic neuroma resection in the department of neuro-surgery from Apr 2000 to Apr 2013,the incidence of the postoperative intracranial infections was statistically ana-lyzed,and the examination indicators were analyzed according to the criteria for diagnosis of intracranial infections after acoustic neuroma resection.RESULTS The intracranial infections occurred in 40 of 312 patients undergoing the surgery with the incidence rate of 12.8%.The results of univariate analysis showed that the incidence of the in-tracranial infections was associated with the advanced age,length of hospital stay more than 20 days,complication of diabetic mellitus,use of hormones,postoperative cerebrospinal fluid leakage,and preoperative use of antibiotics （P〈0.05）.The results of multivariate logistic regression analysis indicated that the operation duration,preopera-tive complication of diabetic mellitus,postoperative cerebrospinal fluid leakage,and use of hormones were the in-dependent risk factors for the intracranial infections.CONCLUSION The incidence of the postoperative intracranial infections is higher in the patients undergoing the acoustic neuroma resection.There are a variety of risk factors for the postoperative intracranial infections,among which the prolonged operation duration,preoperative complication of diabetic mellitus,postoperative cerebrospinal fluid leakage,and use of hormones are the independent risk fac-tors.