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成人脑积水患者脑室-腹腔分流术后颅内感染的风险:一项回顾性研究。

The risk of intracranial infection in adults with hydrocephalus after ventriculoperitoneal shunt surgery: A retrospective study.

机构信息

Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Department of Neurosurgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

Int Wound J. 2020 Jun;17(3):722-728. doi: 10.1111/iwj.13331. Epub 2020 Feb 19.

Abstract

Infection remains the most significant complication of ventriculoperitoneal shunt (VPS) surgery. The objective of this study was to investigate intracranial infections complicating VPS surgery in adults with hydrocephalus. Patients who underwent VPS surgery for hydrocephalus between 2000 and 2016 were included. Clinical data and follow-up evaluations were examined and analysed retrospectively. A total of 502 patients with hydrocephalus who underwent VPS surgery were included. They were followed up for at least 2 years. Twelve patients with incomplete data were excluded. Four hundred and ninety patients were included in the final analysis. Twenty-five cases of intracranial infection occurred, accounting for 5.1% of patients with VPS surgery. The mean age of the patients was 57.1 ± 10.1 years (range, 39-72 years). The incidence of intracranial infection in patients over 60 years of age was higher than that in patients under 60 years of age (P = .007). Age (P = .007), diabetes (P = .026), skin infection (P = .028), bed-ridden (P = .007), and modified operation (P = .011) were highly correlated with the incidence of intracranial infection. The findings of this retrospective study show that age, diabetes, skin infection, bed-ridden, and modified operation of hydrocephalus significantly and independently correlated with the incidence of infection. Prospective studies are needed to assess the relationship between the incidence of infection and risk factors in patients with hydrocephalus after VPS.

摘要

颅内感染仍然是脑室-腹腔分流术(VPS)术后最严重的并发症。本研究旨在探讨成人脑积水患者 VPS 术后并发颅内感染的情况。纳入 2000 年至 2016 年间接受 VPS 手术治疗脑积水的患者。回顾性检查和分析临床资料和随访评估。共纳入 502 例接受 VPS 手术治疗的脑积水患者,至少随访 2 年。排除 12 例资料不完整的患者。最终有 490 例患者纳入最终分析。25 例发生颅内感染,占 VPS 手术患者的 5.1%。患者的平均年龄为 57.1±10.1 岁(范围 39-72 岁)。60 岁以上患者颅内感染的发生率高于 60 岁以下患者(P=.007)。年龄(P=.007)、糖尿病(P=.026)、皮肤感染(P=.028)、卧床不起(P=.007)和改良手术(P=.011)与颅内感染的发生率高度相关。这项回顾性研究的结果表明,年龄、糖尿病、皮肤感染、卧床不起和脑积水的改良手术与感染发生率显著相关且独立相关。需要前瞻性研究来评估 VPS 术后脑积水患者感染发生率与危险因素之间的关系。

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