摘要
目的分析颅骨钻孔侧脑室引流患者术后颅内感染的影响因素。方法选取2010年2月-2018年9月贵州医科大学第三附属医院颅骨手术钻孔侧脑室引流治疗1 605例患者为研究对象,回顾性分析患者临床资料,分析引起颅内感染的病原菌,单因素及多因素Logistic回归模型分析患者发生颅内感染的影响因素。结果 114例进行颅骨钻孔侧脑室引流手术患者发生颅内感染,感染率为7.10%(114/1605)。共分离出126株病原菌,其中革兰阳性菌80株占63.49%,革兰阴性菌42株占33.33%,真菌4株占3.17%。多因素Logistic回归模型分析显示,引流留置时间>3 d、脑脊液漏、引流管松动、血糖>6.11 mmol/L是颅骨钻孔侧脑室引流术后颅内感染的独立影响因素(P<0.05),导管口护理≥2次/日是颅骨钻孔侧脑室引流术后颅内感染的保护因素(P<0.05)。结论颅骨钻孔侧脑室引流患者术后颅内感染影响因素较多,应加强引流管护理,控制血糖,及时评估早期拨管,防止引流管松动与脑脊液漏等是减少颅骨钻孔侧脑室引流术后颅内感染主要措施。
OBJECTIVE To investigate the influencing factors for postoperative intracranial infection in the patients treated with skull drilling for lateral ventricle drainage. METHODS A total of 1 605 patients who received the skull drilling surgery for lateral ventricle drainage in the Third Affiliated Hospital of Guizhou Medical University from Feb. 2010 to Sep. 30, 2018 were recruited as the study objects, the clinical data of the patients were retrospectively analyzed, the pathogens causing the intracranial infection were observed, and the univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the intracranial infection. RESULTS Totally 114 patients who received the skull drilling surgery for lateral ventricle drainage had intracranial infection, with the infection rate 7.10%(114/1605).A total of 126 strains of pathogens were isolated, 80(63.49%) of which were gram-positive bacteria, 42(33.33%) were gram-negative bacteria, and 4(3.17%) were fungi.The multivariate logistic regression analysis showed that the drainage indwelling time more than 3 days, cerebrospinal fluid leakage, loosening of drainage tube, blood glucose more than 6.11 mmmol/L were the independent influencing factors for the postoperative intracranial infection in the patients treated with skull drilling for lateral ventricle drainage(P<0.05), and the frequency of nursing of catheter orifice no less than 2 times per day was the protective factor for the postoperative intracranial infection(P<0.05). CONCLUSION There are a variety of influencing factors for the postoperative intracranial infection in the patients treated with skull drilling for lateral ventricle drainage.It is necessary to strengthen the nursing of drainage tube, control the blood glucose, evaluate the early extubation in a timely manner and prevent the drainage tube from loosening and cerebrospinal fluid leakage so as to reduce the incidence of postoperative intracranial infection in the patients treated with skull drilling for lateral ventricle drainage.
作者
谢朝云
李耀福
蒙桂鸾
熊芸
杨忠玲
田喜贞
杨怀
XIE Zhao-yun;LI Yao-fu;MENG Gui-luan;XIONG Yun;YANG Zhong-ling;TIAN Xi-zhen;YANG Huai(Third Affiliated Hospital of Guizhou Medical University,Tuyun,Guizhou 558000,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第2期212-215,共4页
Chinese Journal of Nosocomiology
基金
贵州省科技厅联合基金资助项目(黔科合LH字[2014]7162号)
贵州省黔南州社会发展科技基金资助项目(黔南科合社字[2015]19号)。
关键词
颅骨钻孔
侧脑室引流
颅内感染
因素分析
Skull drilling
Lateral ventricle drainage
Intracranial infection
Analysis of factor
