颅脑外伤术后颅内感染的危险因素及预防 方法研究

Study on the Risk Factors and Prevention Methods of Intracranial Infection after Craniocerebral Trauma

目的探讨颅脑外伤术后颅内感染的危险因素及预防方法。方法将2018年3月—2019年9月该院收治的200例行颅脑外伤手术治疗患者中80例并发颅内感染患者作为研究对象,对导致颅脑外伤术后颅内感染的单因素进行分析;之后使用Logistic回归分析法对导致颅脑外伤术后颅内感染的多因素进行分析,并根据相关的因素提出具有针对性的预防方法。结果经单因素分析显示,导致颅脑外伤术后颅内感染的因素包括性别,男性感染占比较高42.45%,但差异无统计学意义(χ^(2)=0.565,P=0.452)、年龄60岁以上患者感染居多82.14%(Z=-3.020,P<0.001)、有开放性伤口的患者感染率较高44.07%(χ^(2)=6.528,P=0.011)、术前GCS评分,小于8分的患者出现感染的概率较高73.58%(χ^(2)=33.890,P<0.001)、手术时间,≤2 h的患者感染率较高60.00%(χ^(2)=23.210,P<0.001)、患脑脊液漏的患者感染率较高70.73%(χ^(2)=20.295,P<0.001)、脑室外引流,接受脑室外引流的患者感染率较高57.89%(χ^(2)=6.260,P=0.012)、行气管切开流程的患者感染率更高43.75%,但数据差异无统计学意义(χ^(2)=0.552,P=0.458)、住院时间少于10 d的患者感染率更高40.22%(χ^(2)=0.003,P=0.954)等;经Logistic回归分析法显示,手术时间、脑脊液漏、脑室外引流是导致颅脑外伤术后颅内感染重要因素。结论手术时间、脑脊液漏、脑室外引流是导致颅脑外伤术后颅内感染重要因素,需要对上述因素予以明确并提出相应的解决,以便消除不良症状。

Objective To investigate the risk factors and preventive methods of intracranial infection after craniocerebral trauma. Methods From March 2018 to September 2019, 80 of the 200 patients who underwent surgical treatment of craniocerebral trauma were treated in the hospital and 80 cases of patients with intracranial infection were used as the research objects, and the single factors leading to intracranial infection after craniocerebral trauma were analyzed. Afterwards, the logistic regression analysis method was used to ana-lyze the multiple factors leading to intracranial infection after craniocerebral trauma, and the targeted prevention methods were pro-posed according to the relevant factors. Results Univariate analysis showed that the factors leading to intracranial infection after cran-iocerebral trauma include gender. Male infections accounted for 42.45% higher, but the difference was not statistically significant( χ2=0.565, P=0.452), infections in patients over 60 years of age Mostly 82.14%(Z=-3.020, P<0.05), patients with open wounds have a higher infection rate of 44.07%(χ2=6.528, P=0.011), preoperative GCS score, less than 8 points The probability of infection is 73.58%(χ2=33.890, P<0.001), the operation time is less than 2 hours, the infection rate is higher by 60.00%(χ2=23.210, P<0.001), patients suffering from cerebrospinal fluid leakage The infection rate is 70.73%(χ2=20.295, P<0.001), the ventricular drainage, the infection rate of patients receiving the ventricular drainage is 57.89%(χ2=6.260, P=0.012), tracheotomy The infection rate of patients in the process is 43.75% higher, but the data is not statistically significant(χ2=0.552, P=0.458), and the infection rate of patients with hospitalization less than 10 days is higher by 40.22%(χ2=0.003, P= 0.954), etc.;Logistic regression analysis showed that operation time,cerebrospinal fluid leakage, and ventricular drainage are important factors leading to intracranial infection after craniocerebral trauma.Conclusion Operation time, leakage of cerebrospinal fluid, and ventricular drainage are important factors that lead to intracranial infection after craniocerebral trauma. The above factors need to be clarified and proposed corresponding solutions to eliminate adverse symptoms.