Ⅰ类切口开颅术后颅内感染的相关危险因素分析

Analysis of Related Risk Factors of Intracranial Infection after ClassⅠIncision Craniotomy

【目的】探讨神经外科Ⅰ类切口开颅术后颅内感染的相关危险因素。【方法】回顾性分析2018年1月至2019年12月于本院接受Ⅰ类切口开颅手术的725例患者的临床资料,对可能的危险因素进行单因素分析及多因素Logistic回归分析。【结果】725例患者术后发生颅内感染63例(8.69%)。单因素分析显示,年龄>50岁、体重指数(BMI)>27kg/m^(2)、手术时间>4h、糖尿病史、急诊手术、术中侧脑室开放、未预防性使用抗生素、留置引流管、脑脊液漏、术中使用显微镜是术后发生颅内感染的相关危险因素(P<0.05)。多因素Logistic回归分析显示,年龄、糖尿病史、未预防性使用抗生素、脑脊液漏、留置引流管是术后发生颅内感染的独立危险因素(P<0.05)。【结论】年龄、糖尿病史、未预防性使用抗生素、留置引流管及脑脊液漏是开颅术后颅内感染的危险因素,临床应采取针对性的预防措施对这些危险因素进行早期干预,降低术后颅内感染率。

【Objective】To explore the risk factors of intracranial infection after neurosurgical classⅠincision craniotomy.【Methods】The clinical data of 725 patients who underwent classⅠincision craniotomy in our hospital from January 2018 to December 2019 were analyzed retrospectively.The possible risk factors were analyzed by univariate analysis and multivariate logistic regression analysis.【Results】Intracranial infection occurred in 63 of 725 patients(8.69%).Univariate analysis showed that age>50 years,BMI>27 kg/m2,operation time>4 h,diabetes history,emergency operation,open lateral ventricle,preoperative prophylactic use of antibiotics,drainage tube,postoperative cerebrospinal fluid leakage,and intraoperative microscopy were associated risk factors for intracranial infection after operation(P<0.05).Multivariate Logistic regression analysis showed that age,history of diabetes,preoperative antibiotic use,cerebrospinal fluid leakage,and drainage tube were independent risk factors for intracranial infection after operation(P<0.05).【Conclusion】Age,history of diabetes,preventive use of antibiotics,indwelling drainage tube and cerebrospinal fluid leakage are risk factors for intracranial infection after craniotomy.Clinical preventive measures should be taken to intervene early in these risk factors,so as to reduce the incidence of intracranial infection after operation.