Enger P Ø, Svendsen F, Wester K
Department of Neurosurgery, Haukeland University Hospital, University of Bergen School of Medicine, Bergen, Norway.
Acta Neurochir (Wien). 2003 Apr;145(4):243-8; discussion 248. doi: 10.1007/s00701-002-1068-5.
The objective was to identify risk factors for shunt infections, and establish the rate of infection for shunt procedures carried out under standardized conditions in a well-defined population. All (407) paediatric shunt operations (primary and revisions) performed within a total population of 630000 inhabitants between January 1, 1986 and December 31, 1996, were analysed retrospectively. 11 shunt infections were diagnosed in 10 patients, giving an overall infection rate of 2.7% per procedure and 6.2% per patient. Infections were significantly correlated with age, type of operation, and a etiology of hydrocephalus. Thus, infections occurred more frequently during the first 6 months of life, more often following primary shunt insertions compared with revisions, and children with myelomeningocele had a higher infection risk than children with hydrocephalus due to other causes. There was a highly significant male preponderance in the patient material.
The overall infection rate was relatively low. The risk factors for shunt infections appear to relate to epidemiological characteristics rather than to surgical factors.
目的是确定分流感染的危险因素,并确定在明确界定的人群中在标准化条件下进行的分流手术的感染率。对1986年1月1日至1996年12月31日期间在63万居民总人口中进行的所有(407例)儿科分流手术(初次手术和翻修手术)进行回顾性分析。在10名患者中诊断出11例分流感染,每次手术的总体感染率为2.7%,每名患者的感染率为6.2%。感染与年龄、手术类型和脑积水病因显著相关。因此,感染在生命的前6个月更频繁发生,与翻修手术相比,初次分流植入后感染更常见,脊髓脊膜膨出患儿的感染风险高于其他原因导致脑积水的患儿。患者资料中男性明显占优势。
总体感染率相对较低。分流感染的危险因素似乎与流行病学特征而非手术因素有关。