摘要
目的 分析重型颅脑损伤术后颅内感染的相关危险因素。方法 选取2018年6月至2020年6月兰考第一医院收治的61例行开颅手术治疗的重型颅脑损伤患者作为研究对象,收集患者性别、年龄、手术时间、手术次数、切口脑脊液漏发生情况、脑室外引流时间、是否急诊手术、是否行后颅窝手术、有无开放性颅脑损伤、是否合并基础疾病、白蛋白水平等资料,并根据患者是否发生颅内感染将患者分为感染组与非感染组,多因素Logistic回归分析颅内感染的相关危险因素。结果 61例患者均顺利完成手术,术后出现颅内感染13例(21.31%),设为感染组,未出现颅内感染48例(78.69%),设为非感染组。多因素Logistic回归分析结果显示,手术时间≥4h、手术次数≥2次、切口脑脊液漏、脑室外引流时间≥2d、后颅窝手术、开放性颅脑损伤、白蛋白<35 g/L是重型颅脑损伤患者开颅术后颅内感染的独立危险因素(95%CI为2.111~12.415、1.885~7.463、3.636~62.365、1.505~40.665、2.129~39.184、1.815~6.463、1.636~7.313,P=0.001、 0.001、0.001、0.014、0.003、0.001、0.001)。结论 重型颅脑损伤开颅术后颅内感染的发生与手术时间、手术次数、切口脑脊液漏发生情况、脑室外引流时间、是否行后颅窝手术、有无开放性颅脑损伤以及白蛋白水平密切相关,临床应根据患者具体情况及时做好预防,以减少颅内感染的发生。
Objective To analyze the relevant risk factors for intracranial infection after craniotomy for severe craniocerebral injury.Methods 61 patients with severe craniocerebral injury underwent craniotomy in Lankao First Hospital between June 2018 and June 2020 were enrolled as research subjects,and their data were collected including sex,age,operation time,number of operation,incision cerebrospinal fluid leakage,duration of external ventricular drain,emergency surgery and posterior fossa surgery or not,with open craniocerebral injury or not,complicated with underlying diseases or not,and level of albumin,etc.The patients were divided into infection group and non-infection group based on whether they developed intracranial infection.Multivariate Logistic regression analysis was conducted to analyze relevant risk factors of intracranial infection.Results All the 61 patients underwent surgery successfully,of whom 13 cases(21.31%) developed intracranial infection after surgery were set as infection group,and the other 48 cases(78.69%) without intracranial infection were set as non-infection group.The results of multivariate Logistic regression analysis showed that operation time≥4 h,number of operations ≥2 times,duration of incision cerebrospinal fluid leakage and external ventricular drainage ≥2 d,posterior fossa surgery,open craniocerebral injury and albumin <35 g/L were independent risk factors of intracranial infection after craniotomy in patients with severe craniocerebral injury(95% CI:2.111-12.415,1.885-7.463,3.636-62.365,1.505-40.665,2.129-39.184,1.815-6.463,1.636-7.313,P=0.001,0.001,0.001,0.014,0.003,0.001,0.001).Conclusion The occurrence of intracranial infection after craniotomy for severe craniocerebral injury is closely associated with operation time,number of operations,incision cerebrospinal fluid leakage,duration of external ventricular drain,underwent posterior fossa surgery or not,with open craniocerebral injury or not and level of albumin.Prompt prevention measures should be performed in clinical
作者
孙留涛
胡远征
SUN Liutao;HU Yuanzheng(Respiratory Diseases and Critical Care Department,Lankao First Hospital,Kaifeng,Henan 475300,China)
出处
《中国烧伤创疡杂志》
2022年第5期344-347,共4页
The Chinese Journal of Burns Wounds & Surface Ulcers
关键词
重型颅脑损伤
颅内感染
开颅术后
危险因素
Severe craniocerebral injury
Intracranial infection
After craniotomy
Risk factor
