定期更换外置脑室引流管未能降低脑脊液感染率：一项随机对照试验的结果
Failure of regular external ventricular drain exchange to reduce cerebrospinal fluid infection: result of a randomised controlled trial.
作者信息
Wong G K C, Poon W S, Wai S, Yu L M, Lyon D, Lam J M K
机构信息
Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
出版信息
J Neurol Neurosurg Psychiatry. 2002 Dec;73(6):759-61. doi: 10.1136/jnnp.73.6.759.
BACKGROUND
It is controversial whether regular changes of external ventricular drains can reduce cerebrospinal fluid (CSF) infection.
OBJECTIVE
To carry out a randomised controlled clinical trial over a two year period to determine whether a regular change of ventricular catheter every five days could reduce CSF infection and improve outcome.
METHODS
103 patients requiring external ventricular drains for more than five days and with no evidence of concurrent CSF infection were studied. The patients were randomised to regular change of ventricular catheter (every five days) and no change unless clinically indicated.
RESULTS
The CSF infection rates were 7.8% for the catheter change group and 3.8% for the no change group, respectively (rate ratio = 1.80, 95% confidence interval 0.33 to 9.81, p = 0.50). No significant difference was found in intensive care unit stay, ward stay, or clinical outcome between the two groups.
CONCLUSIONS
Regular changes of ventricular catheter at five day intervals did not reduce the risk of CSF infection. A single external ventricular drain can be employed for as long as clinically indicated.
背景
定期更换外置脑室引流管是否能降低脑脊液（CSF）感染存在争议。
目的
进行一项为期两年的随机对照临床试验，以确定每五天定期更换脑室导管是否能降低脑脊液感染并改善预后。
方法
研究了103例需要外置脑室引流管超过五天且无并发脑脊液感染证据的患者。将患者随机分为定期更换脑室导管组（每五天更换一次）和除非有临床指征否则不更换组。
结果
导管更换组的脑脊液感染率为7.8%，未更换组为3.8%（率比=1.80，95%置信区间0.33至9.81，p=0.50）。两组在重症监护病房住院时间、病房住院时间或临床结局方面均未发现显著差异。
结论
每五天定期更换脑室导管并不能降低脑脊液感染风险。只要有临床指征，单个外置脑室引流管可使用至所需时长。
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