| 张海军,薛长理,闫 妍,曹培超,梁春东,李革军.重型颅脑损伤患者开颅术后颅内感染危险因素分析[J].中国烧伤创疡杂志,2021,(6):401~404. |
| DOI： |
| 中文关键词: 重型颅脑损伤 开颅术 颅内感染 危险因素 |
| 英文关键词:Severe craniocerebral injury Craniotomy Intracranial infection Risk factors |
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| 中文摘要: |
| 【摘要】 目的 分析重型颅脑损伤患者开颅术后颅内感染的危险因素。方法 选取2018年1月至2020年12月开封市中心医院收治的100例行开颅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、高血压病史、糖尿病病史、术前格拉斯哥昏迷评分（GCS）、手术时间、手术次数、颅脑损伤类型、侵入性操作情况、置管情况、切口脑脊液漏情况、脑外室引流情况、抗菌药物使用时间及营养治疗方式等资料，根据术后是否发生颅内感染将患者分为感染组和未感染组，多因素Logistic回归分析颅内感染的相关危险因素。结果 100例重型颅脑损伤患者均顺利完成手术，术后出现颅内感染12例，设为感染组；未出现颅内感染88例，设为未感染组。多因素Logistic回归分析结果显示，有糖尿病、术前GCS≤8分、手术时间＞7 h、手术次数＞1次、有切口脑脊液漏、有脑外室引流、抗菌药物使用时间＞14 d、肠外营养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2.224 ～ 29.338、2.412 ～ 33.584、0.014 ～ 0.923、0.009 ～ 0.223、2.722 ～ 65.319、1.187 ～77.544、0.024 ～0.397、1.557 ～35.980, P = 0.002、0.001、0.042、0.000、0.001、0.034、0.001、0.012)。结论 重型颅脑损伤患者开颅术后颅内感染与糖尿病、术前GCS评分、手术时间、手术次数、切口脑脊液漏、脑外室引流、抗菌药物使用时间密切相关。 |
| 英文摘要: |
| 【Abstract】 Objective To analyze the risk factors for intracranial infection in patients with severe craniocerebral injuries after craniotomy. Methods 100 patients with severe craniocerebral injuries， who underwent craniotomy in Kaifeng Central Hospital from January 2018 to December 2020 were enrolled to collect such patient data as gender， age， history of hypertension， history of diabetes， and preoperative Glasgow Coma Scale (GCS)， surgery time， number of operations， type of craniocerebral injury， invasive operation， catheterization， incision cerebrospinal fluid leakage， external ventricular drain-age， duration of applying antibacterial drugs， and method of nutritional support. The patients were divided into infection group and non-infection group according to the occurrence of intracranial infection after surgery， and the risk factors related to intracranial infection were analyzed using multivariate Logistic regression. Results All the 100 patients with severe craniocerebral injuries underwent surgery successfully， of whom 12 cases developed intracranial infection after surgery were set as infection group and the other 88 cases without intracranial infection were set as the non-infection group. The results of multivariate Logistic regression analysis showed that history of diabetes， preoperative GCS ≤8 points， surgery time ＞ 7 h，number of operations ＞1 time， occurrence of incision cerebrospinal fluid leakage and external ventricular drainage， duration of applying antibacterial drugs ＞ 14 days， parenteral nutrition were independent risk factors for intracranial infection in patients with severe craniocerebral injuries after craniotomy (95% CI为2.224 ～ 29.338、2.412 ～ 33.584、0.014 ～ 0.923、0.009 ～ 0.223、2.722 ～ 65.319、1.187 ～77.544、0.024 ～0.397、1.557 ～35.980， P = 0.002、0.001、0.042、0.000、0.001、0.034、0.001、0.012)。结论 重型颅脑损伤患者开颅术后颅内感染与糖尿病?术前GCS 评分?手术时间?手术次数?切口脑脊液漏?脑外室引流?抗菌药物使用时间以及营养治疗方式密切相关。 |
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