【摘要】 目的探讨颅脑损伤伴发颅内感染患者的临床特点和急性预后的影响因素。方法取本院2013年4月~2015年10月收治的颅脑损伤患者245例为研究对象,回顾性分析245例入选患者的临床资料,统计颅内感染患者临床表现特点,以χ2检验进行颅内感染危险因素的单因素分析,后给予Logistic回归分析,分析影响预后的相关危险因素。结果 245例患者中发生颅内感染颅42例(17.1%),其中头部持续性胀痛37例(88.1%),头痛伴呕吐30例(71.4%),不规则发热35例(83.3%);临床特点包括明显的脑膜刺激征,神经损伤主要以视神经、动眼神经、听神经为主。手术时间、术前GCS评分<8分、开放性颅脑损伤、手术部位在幕上、引流管留置时间超过7 d、脑脊液漏患者、合并糖尿病等因素为颅内感染主要相关危险因素,其中以脑脊液漏为风险最高的感染因素(OR值=7.17)。患者的性别、年龄、术前是否使用抗生素与是否发生颅内感染无明显关系(P>0.05)。结论应根据上述危险因素,及早防控颅内感染;密切关注患者的临床表现,对于颅内感染患者,早发现早治疗。更多还原

【Abstract】 Objective To investigate the clinical characteristics and factors of acute prognosis in traumatic brain injury patients with intracranial infection.Methods The clinical data of 245 patients with traumatic brain injury in our hospital from April 2013 to October 2015 were employed and retrospectively analyzed.The clinical manifestations in intracranial infection patients were collected,and analyzed with chi square test of single factor analysis to find the risk factors of intracranial infection,in which,the significant ones were deal with logistic regression analysis.Results Among of the 245 patients,42 cases(17.1%) occurred with intracranial infection,in which clinical features for persistent head of pain were37 cases(88.1%),headache with vomiting were 30 cases(71.4%),irregular fever were 35 cases(83.3%),.Clinical characteristics included obvious meningeal irritation and nerve injury of optic nerve,oculomotor nerve,auditory nerve.Operative time,preoperative GCS score less than 8 points,open craniocerebral injury,surgical site on the screen,drainage tube indwelling time more than 7 days,leakage of cerebrospinal,diabetes mellitus etc.were for risk factors of intracranial infection related,in which,leakage of cerebrospinal fluid could bring the highest risk(OR value=7.17).There was no significant relationship between sex,age,preoperative use of antibiotics and the occurrence of intracranial infection(P >0.05).Conclusion Prevented the intracranial infection according to the risk factors in the early stage.Paid close attention to the clinical manifestations of patients,to detect the patients with intracranial infection and given treatment as early.更多还原