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多发创伤性开颅术后颅内感染危险因素的Logistic回归分析及预防措施

Logistic Regression Analysis of Risk Factors for Intracranial Infection After Multiple Traumatic Craniotomy and Preventive Measures.

作者信息

Yao Jing, Liu Dong

机构信息

Department of Neurosurgery.

Department of Otorhinolaryngology Head And Neck Surgery, Jiaozhou People's Hospital, Qingdao, China.

出版信息

J Craniofac Surg. 2019 Oct;30(7):1946-1948. doi: 10.1097/SCS.0000000000004972.

DOI:10.1097/SCS.0000000000004972
PMID:31503113
Abstract

BACKGROUND AND OBJECTIVE

The aim of this study was to study the risk factors of intracranial infection after traumatic craniotomy in multiple trauma to provide references for clinical prevention and control of intracranial infection.

METHODS

A total of 34 multiple trauma patients treated with craniotomy and complicated with intracranial infection from February 2012 to December 2016 in the department of neurosurgery of our hospital were selected as infection group, and 60 multiple trauma patients who had not been infected after craniotomy during the same period were selected as control group. Related risk factors were screened by univariate analysis at first and analyzed by Logistic regression.

RESULTS

Of the 34 patients in the infection group, 13 cases were cured, 21 cases improved, whereas in the control group, 15 cases were cured and 45 cases improved. There was no significant difference in prognosis between the 2 groups (P > 0.05). Univariate analysis showed that surgical approach, surgical duration, postoperative cerebrospinal fluid leakage, and external drainage were important factors for intracranial infection after craniotomy (P < 0.05). Further Logistic regression analysis showed that postoperative external drainage, cerebrospinal fluid leakage, surgical time, and posterior fossa approaches were independent risk factors for intracranial infection after craniotomy.

CONCLUSION

High attention should be paid to the risk factors of intracranial infection after craniotomy such as postoperative cerebrospinal fluid leakage, external drainage, surgical duration and approach, and taking effective preventive measures to reduce the incidence of intracranial infection after craniotomy in patients with multiple traumatic injuries.

摘要

背景与目的

本研究旨在探讨多发伤患者开颅术后颅内感染的危险因素,为临床预防和控制颅内感染提供参考。

方法

选取2012年2月至2016年12月在我院神经外科行开颅手术并并发颅内感染的34例多发伤患者作为感染组,同期选取60例开颅术后未发生感染的多发伤患者作为对照组。首先采用单因素分析筛选相关危险因素,再进行Logistic回归分析。

结果

感染组34例患者中,13例治愈,21例好转;对照组60例患者中,15例治愈,45例好转。两组患者预后差异无统计学意义(P>0.05)。单因素分析显示,手术入路、手术时间、术后脑脊液漏及外引流是开颅术后颅内感染的重要因素(P<0.05)。进一步Logistic回归分析显示,术后外引流、脑脊液漏、手术时间及后颅窝入路是开颅术后颅内感染的独立危险因素。

结论

应高度重视开颅术后颅内感染的危险因素,如术后脑脊液漏、外引流、手术时间及手术入路等,并采取有效的预防措施,以降低多发伤患者开颅术后颅内感染的发生率。

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