【摘要】 目的　研究开颅手术后继发颅内感染的危险因素和治疗方法。方法　回顾性分析过去6 年内的991 例开颅手术,总结分析颅内感染的危险因素和抗生素治疗方案。结果　颅内感染率为3.7%,脑脊液培养阳性率仅为5.4%;幕下开颅手术后颅内感染率为13.5%,幕上开颅手术后的颅内感染率为2 9%(P=0 000);显微手术的颅内感染率为5.1%,非显微手术的颅内感染率为2.0%(P= 0.011);急诊开颅手术颅内感染率为2.7%,而择期开颅手术的颅内感染率为4.0%(P=0.544)。结论　显微手术和幕下开颅手术是颅内感染的危险因素;颅内感染的经验性治疗仍然是重要的治疗手段,要结合各单位的抗生素的耐药状况选择合适的抗生素。更多还原

【Abstract】 OBJECTIVE To investigate the risk factors and treatment of nosocomial cerebrospinal fluid (CSF) infection in patients undergoing craniotomy. METHODS A total of 991 patients undergoing craniotomy from 1998 to 2003 were studied retrospectively, 37 developed CSF infection. The risk factors of nosocomial CSF infection and its treatment were reviewed. RESULTS The incidence of nosocomial CSF infection was 3.7% in this series. The CSF culture for etiologic agents was carried out in all the 37 patients with CSF infection, but only 2 had positive results. The incidence of CSF infection was significantly higher in infratentorial craniotomy than that in supratentorial craniotomy (13.5% vs 2.9%, P=0.000). 5.1% of the microsurgeries developed CSF infection, vs 2.0% of the non-microsurgeries (P=0.011). The incidence of CSF infection in emergency craniotomy was 2.7%, and 4.0% in elective craniotomy (P=0.544). CONCLUSIONS Microsurgery and infratentorial craniotomy are the risk factors of nosocomial CSF infection. Empirical treatment for postsurgical nosocomial CSF infection appears to be very important according to our study. Antibacterials should be chosen with regard to the bacteria-sensitivity test in each medical unit.更多还原