【摘要】 目的分析脑外伤开颅患者围手术期发生颅内感染的相关影响因素,为临床工作中预防和控制颅内感染,改善患者预后提供理论依据。方法搜集我院自2016年至2018年收治的脑外伤并行颅脑手术的患者,根据术后是否发生颅内感染将528例行开颅手术的脑外伤患者分为颅内感染组和未颅内感染组。采取多因素logistic回归模型对2组的临床资料进行回顾性分析。结果颅脑手术后颅内总体感染发生率为10.42%。在术前影响颅内感染的因素中,颅脑损伤的类型、格拉斯哥评分的高低、术中是否置入材料、手术时间的长短、术后手术切口是否存在脑脊液漏、术后引流管放置时间的长短、术后空腹血糖、术后白蛋白所占比例与未颅内感染组比较差异均有统计学意义(P<0.05)。结论脑外伤开颅术后患者围手术期的颅内感染与多种因素有关,颅脑损伤为开放性损伤、损伤较重的病人(GCS<8分)、术中手术的暴露时间超过4小时、术中置入人工材料、术后放置引流及引流时间超过7天、术后空腹血糖≥7mmol·L-1、术后存在低蛋白血症是引起颅内感染的相关因素。围手术期对颅内感染影响因素采取有效的预防及控制,可以有利于减少颅脑外伤术后颅内感染的发生。更多还原

【Abstract】 Objective To analyze the influencing factors of intracranial infection in patients with brain trauma and craniotomy, and to provide theoretical basis for prevention and control of intracranial infection and improvement of prognosis in clinical work. Methods Patients with brain trauma and brain surgery admitted to our hospital from 2016 to 2018 were enrolled. According to whether intracranial infection occurred after operation, 528 patients with brain trauma who underwent craniotomy were divided into intracranial infection group and non-intracranial Infected group. A multivariate logistic regression model was used to retrospectively analyze the clinical data of the two groups. Results The overall incidence of intracranial infection after craniocerebral surgery was 10.42%. Among the factors affecting intracranial infection before surgery, Craniocerebral injury was open injury, severe injury(GCS <8 points), intraoperative surgery exposure time of more than 4 hours, intraoperative placement of artificial materials, postoperative drainage and drainage time of more than 7 days, postoperative Fasting blood glucose ≥7 mmol·L-1, postoperative hypoproteinemia is a related factor causing intracranial infection. Conclusions Perioperative intracranial infection in patients with traumatic brain injury after craniotomy is associated with multiple factors, open craniocerebral injury, preoperative GCS score <8 points, postoperative drainage tube placement time ≥7 d, intraoperative placement of materials, Postoperative albumin <30 g·L-1 and postoperative incision cerebrospinal fluid leakage are risk factors for postoperative intracranial infection. Effective prevention and control of factors affecting intracranial infection during perioperative period can help reduce the incidence of intracranial infection after craniocerebral trauma.更多还原