摘要
目的探讨外科治疗颅脑肿瘤患者颅内感染的相关脑脊液致病菌及耐药性,为临床感染防治提供参考。方法回顾性分析2014年3月-2017年3月医院收治的430例颅脑肿瘤患者的临床资料,探讨颅内感染情况及相关因素,并对颅内感染患者进行脑脊液病原菌培养及药敏试验,对其结果进行分析。结果颅脑肿瘤患者中有51例患者发生颅内感染,发生率为11.86%;脑脊液培养均阳性,共培养出26株致病菌,其中革兰阴性菌10株占38.46%,革兰阳性菌16株占61.54%;单因素分析结果显示,发生颅内感染的相关影响因素为患者手术时间和次数、后颅窝手术、脑室外引流、切口脑脊液漏以及术后血清白蛋白水平,多因素Logistic回归分析结果显示,手术时间、切口脑脊液外流、后颅窝手术以及脑室外引流是颅脑肿瘤患者发生颅内感染的独立影响因素。结论颅脑肿瘤患者发生颅内感染的因素较多,临床上需根据相关因素及脑脊液培养制定和调整治疗方案,以降低颅内感染的发生率。
OBJECTIVE To explore the distribution and drug resistance of pathogens isolated from cerebrospinal fluid specimens of the intracranial tumor patients with intracranial infection so as to provide guidance for clinical prevention and treatment of the infection.METHODS The clinical data of 430 patients with intracranial tumor who were treated in the hospital from Mar 2014 to Mar 2017 were retrospectively analyzed,the incidence of intracranial infection and related factors for the infection were observed,the culture of cerebrospinal fluid was carried out for the patients with intracranial infection,and the drug susceptibility testing was performed.RESULTS Of the patients with intracranial tumor,51 had intracranial infection,with the incidence rate 11.86%.All of the cerebrospinal fluid specimens were cultured positive;totally 26 strains of pathogens were isolated,10(38.46%)of which were gram-negative bacteria,and 16(61.54%)were gram-positive bacteria.The result of univariate analysis indicated that the influencing factors for the intracranial infection included the duration and number of times of operation,post-cranial fossa surgery,external ventricular drainage,incision cerebrospinal fluid leakage and postoperative serum albumin level.The result of multivariate logistic regression analysis showed that the operation duration,incision cerebrospinal fluid leakage,post-cranial fossa surgery and external ventricular drainage were the independent influencing factors for the intracranial infection in the patients with intracranial tumor.CONCLUSIONThere are a variety of influencing factors for the intracranial infection in the patients with intracranial tumor,and it is necessary for the hospital to put forward and adjust the treatment schemes according to the related factors and the result of culture of cerebrospinal fluid so as to reduce the incidence of intracranial infection.
作者
戴缤
朱广通
肖智勇
毛贝贝
黄辉
关峰
苏海洋
林镇阳
彭伟澄
胡志强
DAI Bin;ZHU Guang-tong;XIAO Zhi-yong;MAO Bei-bei;HUANG Hui;GUAN Feng;SU Hai-yang;LIN Zhen-yang;PENG Wei-cheng;HU Zhi-qiang(Beijing Shijitan Hospital,Capital Medical University,Beijing100038,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第9期1367-1370,共4页
Chinese Journal of Nosocomiology
基金
北京市医院管理局"青苗"计划专项基金资助(QML20170702)
首都医科大学附属北京世纪坛医院资助项目基金(2015-C11)
关键词
外科治疗
颅内肿瘤
颅内感染
脑脊液致病菌
耐药性
Surgical treatment
Intracranial tumor
Intracranial infection
Pathogen isolated from cerebrospinal fluid
Drug resistance
