颅内动脉瘤夹闭手术患者医院感染病原菌特点及危险因素分析

Pathogenic characteristics and risk factors of hospital infection in patients undergoing intracranial aneurysm clipping surgery

目的:调查动脉瘤夹闭手术患者医院感染情况,分析医院感染相关危险因素。方法:回顾性调查某三级甲等综合医院神经外科2019年1月1日至2021年12月31日行颅内动脉瘤夹闭手术的282例患者的临床资料,对其临床资料进行单因素及多因素分析。结果:282例动脉瘤夹闭手术患者医院感染发生率为21.63%,医院感染例次发生率为24.11%。单因素分析显示,年龄、动脉瘤破裂、术前GCS评分、术前HH评分、侵入性操作、术后入住ICU、住院时间、深静脉血栓、头部引流管留置时间、手术持续时间10个因素对动脉瘤夹闭手术患者发生医院感染影响显著,具有统计学差异(P<0.05);多因素分析显示,入住ICU、年龄大于65岁、腰椎穿刺及腰大池引流是动脉瘤夹闭手术患者发生医院感染的独立危险因素。结论:动脉瘤夹闭手术患者医院感染发生率高,感染的发生是多种因素共同作用的结果。其中,入住ICU、年龄大于65岁、腰椎穿刺及腰大池引流是动脉瘤夹闭手术患者发生医院感染的独立危险因素。

Objective:Investigate the hospital infection status of patients undergoing aneurysm clipping surgery and analyze the risk factors related to hospital infection.Methods:The clinical data of 282 patients who underwent intracranial aneurysm clip-ping surgery in Neurosurgery department of a tertiary A-level general hospital from January 1,2019 to December 31,2021 were retrospectively investigated,and their clinical data were analyzed by single factor and multi factor analysis.Results:The incidence of hospital infection in 282 patients undergoing aneurysm clipping surgery was 21.63%,and the incidence of hospital infection cases was 24.11%.Univariate analysis showed that age,aneurysm rupture,preoperative GCS score,preoperative HH score,invasive operation,admission to ICU after surgery,length of hospital stay,Deep vein thrombosis,retention time of head drainage tube,and duration of surgery had significant effects on hospital infection in patients undergoing aneurysm clip-ping surgery,with statistical differences(P<0.05);Multivariate analysis showed that admission to ICU,age over 65,Lum-bar puncture and lumbar cistern drainage were independent risk factors for nosocomial infection in patients undergoing aneurysm clipping surgery.Conclusion:The incidence of hospital infection in patients undergoing aneurysm clipping surgery is high,and the occurrence of infection is the result of multiple factors working together.Among them,admission to ICU,age over 65,Lumbar puncture and lumbar cistern drainage are independent risk factors for hospital infection in patients undergoing aneurysm clipping surgery.