摘要
【目的】探讨经鼻内镜颅低手术(EESBS)患者并发颅内感染的危险因素,对临床提供指导建议。【方法】选取我院2016年1月至2020年8月接受EESBS手术后发生颅内感染的患者68例作为感染组、同期手术未发生颅内感染的患者70例作为对照组;统计分析感染组患者病原菌感染分布特征、脑脊液化验结果,并采用单因素及多因素分析法探讨EESBS患者并发颅内感染的危险因素。【结果】68例发生颅内感染的患者,其中革兰氏阳性菌感染41例(60.29%),主要为金黄色葡萄球菌19例(27.94%)、表皮葡萄球菌8例(11.76%);革兰氏阴性菌感染27例(39.71%),主要为不动杆菌属9例(13.24%)、大肠埃希菌7例(10.29%);68例发生颅内感染的患者进行脑脊液化验,WBC>10×10^(6)/L 68例(100%)、脑脊液脓性表现17例(25.00%)、脑脊液浑浊43例(63.24%)、蛋白>0.45 g/L 39例(57.35%)、葡萄糖<2.25 mmol/L 31例(45.59%)、氯化物<120.0 mmol/L 34例(50.00%);Logistic回归模型,结果显示颅底重建、脑脊液鼻漏、脑室外引流或腰大池引流是EESBS手术后发生颅内感染的独立危险因素(P<0.05),术前预防性使用抗生素可有效降低EESBS手术后发生颅内感染的风险(P<0.05)。【结论】EESBS手术后发生颅内感染的危险因素较多,应该针对风险较大的患者给与针对性预防措施降低颅内感染的发生率。
【Objective】To explore the risk factors of intracranial infection in patients with endoscopic endoscopic cranial surgery(EESBS),and provide clinical guidance and suggestions.【Methods】A total of 68 patients with intracranial infection after EESBS surgery in our hospital from January 2016 to August 2020 were selected as the infection group,and 70 patients without intracranial infection during the same period were selected as the control group;the infection group was statistically analyzed for pathogen infection Distribution characteristics,cerebrospinal fluid test results,and single factor and multivariate analysis were used to explore the risk factors of EESBS patients with intracranial infection.【Results】Of 68 patients with intracranial infection,41 cases(60.29%)were infected by Gram-positive bacteria,19 cases(27.94%)were mainly Staphylococcus aureus,and 8 cases(11.76%)were Staphylococcus epidermidis;Gram-negative 27 cases(39.71%)of bacterial infection,9 cases(13.24%)of Acinetobacter genus,7 cases(10.29%)of Escherichia coli;68 cases of intracranial infection were tested for cerebrospinal fluid,WBC>10×10^(6)/L 68 cases(100%),cerebrospinal fluid purulent manifestations in 17 cases(25.00%),cerebrospinal fluid turbidity in 43 cases(63.24%),protein>0.45 g/L in 39 cases(57.35%),glucose<2.25 mmol/L in 31 cases(45.59%),chloride<120.0 mmol/L 34 cases(50.00%);Logistic regression model,the results showed that skull base reconstruction,cerebrospinal fluid rhinorrhea,ventricular drainage or lumbar cistern drainage are independent of intracranial infection after EESBS surgery Risk factors(P<0.05),preoperative use of antibiotics can effectively reduce the risk of intracranial infection after EESBS surgery(P<0.05).【Conclusion】There are many risk factors for intracranial infection after EESBS surgery,and targeted preventive measures should be given to patients with higher risk to reduce the incidence of intracranial infection.
作者
童瑜
余舟
张国乐
顾应江
TONG Yu;YU Zhou;ZHANG Guo-le;GU Ying-jiang(Department of Neurosurgery,First People's Hospital of Zigong City,Zigong Sichuan 643000,China)
出处
《武警后勤学院学报（医学版）》
CAS
2021年第6期47-50,共4页
Journal of Logistics University of PAP（Medical Sciences）
关键词
经鼻内镜颅低手术
颅内感染
危险因素
病原菌
脑脊液
Endoscopic cranial surgery
Intracranial infection
Risk factors
Pathogenic bacteria
Cerebrospinal fluid
