重型颅脑损伤患者术后颅内感染相关临床因素分析

Analysis of Clinical Factors Related to Postoperative Intracranial Infection in Patients with Severe Head Injury

目的探讨重型颅脑损伤患者术后颅内感染相关临床因素。方法回顾性分析了2014年8月—2017年12月收治的50例重型颅脑损伤患者的临床资料,根据术后颅内感染情况将患者分为感染组和非感染组,比较两组患者的性别比例、年龄、手术次数、手术时间、术前GCS评分、术后白蛋白水平等,分析引起术后颅脑感染的因素,并采用Logistics统计方法对其中的高危因素进行回归分析。结果两组患者的性别比例差异无统计学意义(P>0.05),感染组患者中年龄在55岁及以上占83.3%、手术次数为1次占83.3%、手术时间在3 h及以上占66.7%、术前GCS评分在8分以下占100%、术后白蛋白水平在35以下占83.3%,比例均明显高于非感染组,差异有统计学意义(χ~2=4.873、4.291、4.674、5.156、5.364,P<0.05)。颅内感染的5个高危因素中,影响由大到小依次排序为:术前GCS评分(危险性最高,OR=3.529)、手术时间、年龄、术后白蛋白、手术次数,差异有统计学意义(χ~2=4.873、4.291、4.674、5.156、5.364,P<0.05,OR=3.074、2.787、3.281、3.529、3.052,OR>1)。结论高龄、手术次数、手术时间、术前GCS评分、术后白蛋白水平均是发生颅内感染的影响因素,临床应及时防范。

Objective To investigate the clinical factors related to postoperative intracranial infection in patients with severe head injury. Methods The clinical data of 50 patients with severe craniocerebral injury admitted from August 2014 to December 2017 were retrospectively analyzed. Patients were divided into infected group and non-infected group according to postoperative intracranial infection. Sex ratio, age, number of operations, operation time, preoperative GCS score, postoperative albumin level, etc., were used to analyze the factors causing postoperative craniocerebral in- fection, and the risk factors were used for regression analysis. Results There was no significant difference in the sex ra- tio between the two groups. In the infected group, 83.3% of the patients aged 55 years and older, 83.3% of the opera- tion times, and 66.7% of the operation time were 3 hours or more. The GCS score was 100% below 8 points, and the postoperative albumin level was 83.3% below 35. The proportions were significantly higher than those in the non-in- fected group, the different was statistically significant （X==4.873, 4.291, 4.674, 5.156, 5.364, P〈0.05）.Among the five high-risk factors of intracranial infection, the order of influence from large to small was preoperative GCS score （high- est risk, OR =3.529）, operation time, age, postoperative albumin, number of operations, the different was statistically significant（χ2=4.873, 4.291, 4.674, 5.156, 5.364, P〈0.05, OR= 3.074, 2.787, 3.281, 3.529, 3.052, the different was sta- tistically significant （OR〉I）. Conclusion The age, the number of operations, the operation time, the preoperative GCS score, and the postoperative albumin level are the influencing factors of intracranial infection. The clinical should be prevented in time.