颅脑手术患者手术部位感染危险因素分析

Risk factors for surgical sites infection in patients undergoing craniotomy

目的分析造成颅脑手术患者术后手术部位感染(SSI)可能的危险因素,为预防与控制SSI提供理论依据。方法前瞻性、目标性监测545例颅脑手术患者,采用SPSS 19.0软件处理研究数据。结果 545例患者中32例发生SSI,感染率为5.87%;单因素分析显示,手术时间≥4 h、术中失血量≥300 ml、未预防性应用抗菌药物、术后及全部住院天数延长是SSI发生的高危因素(P均<0.05);经Logistic回归分析,预防性应用抗菌药物是SSI发生的独立保护性因素(OR=0.256、95%CI:0.090~0.726),全部住院天数延长是独立的危险性因素(OR=6.601、95%CI:1.136~38.350)。结论颅脑手术患者SSI的发生是多因素共同作用的结果,临床工作中需积极采取综合性措施进行干预,以降低SSI的发生。

Objective To investigate the risk factors for surgical site infection（SSI） in patients with craniotomy,and to provide reference for prevention and control strategies of SSI.Methods Total of 545 patients after craniocerebral operation were observed by prospective targeted surveillance method.The clinical data were analyzed by statistical software SPSS 19.0.Results Among the 545 cases,32 had postoperative SSI,the infection rate was 5.87%.The univariate analysis showed that longer than 4 hours of operation time,intraoperative blood loss more than 300 ml,without prophylactic use of antibiotics,prolonged postoperative and overall hospitalization were high risk factors for SSI（all P〈0.05）.The multivariate logistic regression analysis suggested that prophylactic use of antibiotics was an independently protective factor for SSI（OR =0.256,95%CI：0.090-0.726）,while the prolonged overall hospitalization was an independently risk factor for the occurrence of SSI（OR = 6.601,95%CI：1.136-38.350）.Conclusions The incidence of SSI among patients undergoing craniotomy was the combined effect of several factors.Comprehensive interventions should be actively adopted,in order to reduce the rate of surgical sites infection.