536例开颅手术患者手术部位感染影响因素的Logistic回归分析

Logistic regression analysis of risk factors for surgical site infection in 536 cases of craniotomy

目的分析某三甲医院神经外科手术部位感染(SSI)发生率及其影响因素,为制定SSI预防与控制策略提供依据。方法回顾性调查2017年1月-2017年12月某院神经外科536例开颅手术患者临床资料,调查的内容包括:患者的一般情况、基础疾病、手术信息、颅内感染情况等。对手术部位感染的影响因素进行非条件Logistic回归分析。结果 536例颅脑手术患者中,52例发生SSI,SSI发生率为9.70%;Logistic回归分析结果显示,后颅窝手术、腰大池置管引流、脑脊液漏、手术时间>4h、引流时间长5项因素是颅脑手术SSI的独立危险因素(P<0.05)。结论开颅手术SSI存在多种影响因素,应重视并针对其危险因素制定干预措施,以降低SSI发生率。

OBJECTIVE To analyze the incidence and risk factors of surgical site infection (SSI) in neurosurgical patients in a tertiary first-class hospita and provide reference for the prevention and control of SSI. METHODS The clinical data of patients who underwent craniotomy in the department of neurosurgery of a hospital from Jan. 2017 to Dec. 2017 were surveyed retrospectively. The contents of the investigation included: the patient's general situation, underlying diseases, operation information, intracranial infections, etc. The related risk factors for SSI were analyzed by unconditional Logistic regression analysis. RESULTS Among the 536 patients who underwent craniotomy, 52 (9.70%) had SSI. Logistic regression analysis showed that posterior fossa surgery, lumbar cisterna drainage, cerebrospinal fluid leakage, operation time>4h, and long-term drainage were independent risk factors for SSI after craniotomy(all P<0.05). CONCLUSION There are multiple risk factors for SSI after craniotomy. It is necessary to pay close attention and formulate preventive measures, so as to effectively reduce the occurrence of SSI.