摘要
目的探讨脑出血微创术后外引流致颅内感染的相关因素分析，为进一步预防及治疗提供理论依据。方法回顾性分析2005年2月-2011年12月行微创穿刺外引流术治疗的260例患者临床资料。结果260例自发性脑出血行微创穿刺外引流术治疗患者，发生颅内感染30例，感染率11. 54% ;年龄在20-60岁的感染率为8.00%,〉60岁的感染率18. 00%，两者差异有统计学意义（P〈0. 05）;留置管时间〈5 d感染率6. 43%，留置管时间〉5 d感染率17. 50%，两者差异有统计学意义（P〈0. 05）;单管外引流感染率7. 06%，双管感染率20.00%,两者差异有统计学意义（P〈0. 01）;脑内血肿腔引流感染率5. 56%，脑室内引流感染率21. 43%，两者差异有统计学意义（P〈0. 01）;血肿腔注射尿激酶感染14. 86%，未注射尿激酶感染率4. 71%，两者差异有统计学意义（P〈0.05）;存在并发症的感染率20. 69%，无并发症的感染率6. 94%，两者差异有统计学意义（P〈0. 01）;拔管后有脑脊液漏的感染率26. 15%，无脑脊液漏的感染率6. 67%，两者差异有统计学意义（P〈0. 01 ）；GCS评分越低则感染率越高。结论随着微创手术的广泛应用，正确处理与分析术后的并发症显得特别重要，正确使用抗菌药物、尽可能缩短置管时间、正确放置引流袋、合理注射尿激酶及加强营养、预防其他并发症是预防感染的重要措施。
OBJECTIVE To explore the risk factors of intracranial infections after micro-invasive drainage treatmentof the patients with spontaneous cerebral hemorrhage so as to provide theoretical bases for further prevention andtreatment. METHODS The clinical data of 260 patients treated with micro-invasive drainage from Feb 2005 to Dec2011 were retrospectively analyzed. RESULTS Of totally 260 cases of patients with spontaneous cerebral hemorrhage, 30 cases （11. 5%） of intracranial infection were found; the infection rate of the patients aged between 20and 60 years old was 8. 00% , the infection rate of the patients aged more than 60 years old 18. 00 %,the differencebetween the two group was significant （P〈0. 05） ;the patients with the duration of indwelling less than 5 days hada lower infection rate than did those with the duration of indwelling more than 5 days （6. 43% vs 17. 50%）,thedifference was significant （P〈0. 05） ; the patients using single catheter had a lower infection rate than did thoseusing dual catheters （7. 06% vs 20. 00%）,the difference was significant （P〈0. 01）; the infection rate of thepatients who underwent the intracerebral hematoma cavity drainage was 5. 56%,the patients who underwent theventricular drainage 21. 43%,the difference between the two groups was significant （P〈0. 01） ; the infection rateof the patients with the hematoma cavity injected with urokinase was 14. 86 %,the patients without being injectedwith urokinase 4.71%, the difference was significant （P〈0. 05） ; the infection rate of the patients with complications was 20. 69%,the patients without complication 6. 94% , the difference was significant （P〈0. 01） ; the infection rate of the patients with the leakage of cerebrospinal fluid after removal of the catheter was 26. 15%,the patients without the leakage of cerebrospinal fluid 6. 67% , the difference was significant （P〈0. 01）. In addition, the lower the GCS score, the greater the infection rate was. CONCLUSION With the widespread use of micro-inva- sive surgery, it is important to properly analyze and treat the postoperative complications. The measures for the prevention of postoperative infections include the reasonable application of antibiotics, shortening the duration of indwelling, correct positioning of drainage pack, rational injection of urokinase, and nutrition reinforcement as well as prevention of other complications.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第17期4168-4170,共3页
Chinese Journal of Nosocomiology
关键词
颅内出血
外科手术
微创性
术后并发症
Intracranial hemorrhage
Surgery
Micro-invasive
Postoperative complication
