摘要
目的分析急性脑出血患者血肿清除术后颅内感染的高危因素以及血清神经元特异性烯醇化酶(NSE)、血管紧张素II(Ang-II)、丙二醛(MDA)指标诊断的价值。方法以2017年11月-2019年11月武警海警总队医院收治的行微创血肿清除术的118例急性脑出血患者为研究对象,根据术后是否发生颅内感染分为感染组37例和未感染组81例,收集两组患者的临床资料,采用单因素及多因素Logistic回归分析诱发术后颅内感染的高危因素;利用受试者工作特征曲线(ROC)评估NSE、Ang-II、MDA水平诊断术后颅内感染的效能。结果多因素Logistic回归分析显示:GCS评分<9分、合并糖尿病、引流管留置时间≥3 d、脑脊液漏等是术后颅内感染的独立危险因素(P<0.05);感染组患者血清NSE、Ang-II、MDA水平均高于未感染组,且不同感染程度患者NSE、Ang-II、MDA水平比较有统计学差异(P<0.05);ROC结果显示:血清NSE、Ang-II、MDA水平诊断术后颅内感染的曲线下面积分别为0.893、0.883、0.904,95%CI分别为0.821~0.966、0.815~0.950、0.826~0.982,截断值为6.855 ng/L、41.870 ng/L、3.570μmol/L。结论GCS评分<9分、合并糖尿病、引流管留置时间≥3 d、脑脊液漏患者的感染风险较高,早期检测血清NSE、Ang-II、MDA水平对颅内感染的诊断有较高的借鉴价值。
OBJECTIVE To analyze the high risk factors for postoperative intracranial infection in acute cerebral hemorrhage patients undergoing hematoma evacuation and study the diagnostic value of serum neuron-specific enolase(NSE),angiotensin II(Ang-II)and malondialdehyde(MDA).METHODS A total of 118 patients with acute cerebral hemorrhage who underwent minimally invasive hematoma evacuation in Hospital of Armed Police and Marine Police Corps from Nov 2017 to Nov 2019 were recruited as the study objects and divided into the infection group with 37 cases and the non-infection group with 81 cases according to the status of postoperative intracranial infection,the clinical data were collected from the two groups of patients,univariate analysis and multivariate logistic regression analysis were performed for the high risk factors for the postoperative intracranial infection,and the efficiencies of NSE,Ang-II and MDA in diagnosis of the postoperative intracranial infection were evaluated by using receiver operating characteristic(ROC)curve.RESULTS Multivariate logistic regression analysis showed that the GCS score less than 9 points,complication with diabetes mellitus,drainage tube indwelling time no less than 3 days and leakage of cerebrospinal fluid were the independent risk factors for the postoperative intracranial infection(P<0.05).The levels of serum NSE,Ang-II and MDA of the infection group were higher than those of the non-infection group,and there were significant differences in the levels of NSE,Ang-II and MDA among the patients with different degree of infection(P<0.05).ROC curve analysis indicated that the areas under curve of the serum NSE,Ang-II and MDA were respectively 0.893,0.883 and 0.904 in diagnosis of postoperative intracranial infection,95%CI were respectively 0.821~0.966,0.815~0.950 and 0.826~0.982,and the cutoff values were respectively 6.855 ng/L,41.870 ng/L and 3.570μmol/L.CONCLUSION The patients with the GCS score less than 9 points,complication with diabetes mellitus,drainage tube indwelling time no
作者
马双媛
杨欣刚
彭国琴
王宝祥
陆丽燕
MA Shuang-yuan;YANG Xin-gang;PENG Guo-qin;WANG Bao-xiang;LU Li-yan(Hospital of Armed Police and Marine Police Corps,Jiaxing,Zhejiang314000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第5期646-649,共4页
Chinese Journal of Nosocomiology
基金
嘉兴市科技计划基金资助项目(2018AD32056)。
关键词
急性脑出血
血肿清除术
颅内感染
高危因素
血清学指标
Acute cerebral hemorrhage
Hematoma evacuation
Intracranial infection
High risk factor
Serological index
