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机器人辅助 SEEG 和癫痫切除术之间的手术间隔是 SSI 的影响因素。

The surgical interval between robot-assisted SEEG and epilepsy resection surgery is an influencing factor of SSI.

机构信息

Department of Infection Management and Disease Control, Chinese PLA General Hospital, The 1st Medical Center, Fuxing Road No. 28, Beijing, 100853, China.

Central Sterile Supply Department, Ningxia People's Armed Police Corps Hospital, South Qinghe Street No. 895, Yinchuan, 750001, China.

出版信息

Antimicrob Resist Infect Control. 2024 Jul 26;13(1):81. doi: 10.1186/s13756-024-01438-w.

Abstract

BACKGROUND

In recent years, the development of robotic neurosurgery has brought many benefits to patients, but there are few studies on the occurrence of surgical site infection (SSI) after robot-assisted stereoelectroencephalography (SEEG). The purpose of this study was to collect relevant data from robot-assisted SEEG over the past ten years and to analyze the influencing factors and economic burden of surgical site infection.

METHODS

Basic and surgical information was collected for all patients who underwent robot-assisted SEEG from January 2014 to December 2023. Logistic regression was used to analyze the factors influencing SSI according to different subgroups (radiofrequency thermocoagulation or epilepsy resection surgery).

RESULTS

A total of 242 subjects were included in this study. The risk of SSI in the epilepsy resection surgery group (18.1%) was 3.5 times greater than that in the radiofrequency thermocoagulation group (5.1%) (OR 3.49, 95% CI 1.39 to 9.05); this difference was statistically significant. SSI rates in the epilepsy resection surgery group were associated with shorter surgical intervals (≤ 9 days) and higher BMI (≥ 23 kg/m) (6.1 and 5.2 times greater than those in the control group, respectively). Hypertension and admission to the intensive care unit (ICU) were risk factors for SSI in the radiofrequency thermocoagulation group. Patients with SSIs had $21,231 more total hospital costs, a 7-day longer hospital stay, and an 8-day longer postoperative hospital stay than patients without SSI.

CONCLUSIONS

The incidence of SSI in patients undergoing epilepsy resection after stereoelectroencephalography was higher than that in patients undergoing radiofrequency thermocoagulation. For patients undergoing epilepsy resection surgery, prolonging the interval between stereoelectroencephalography and epilepsy resection surgery can reduce the risk of SSI; At the same time, for patients receiving radiofrequency thermocoagulation treatment, it is not recommended to enter the ICU for short-term observation if the condition permits.

摘要

背景

近年来,机器人神经外科的发展给患者带来了诸多益处,但有关机器人辅助立体脑电图(SEEG)术后手术部位感染(SSI)发生的研究较少。本研究旨在收集过去十年间机器人辅助 SEEG 的相关数据,并分析 SSI 的影响因素及经济负担。

方法

收集 2014 年 1 月至 2023 年 12 月期间所有接受机器人辅助 SEEG 的患者的基本和手术信息。根据不同亚组(射频热凝或癫痫切除术)采用逻辑回归分析影响 SSI 的因素。

结果

本研究共纳入 242 例患者。癫痫切除术组 SSI 风险(18.1%)是射频热凝组(5.1%)的 3.5 倍(OR 3.49,95%CI 1.39~9.05),差异有统计学意义。癫痫切除术组 SSI 发生率与手术间隔较短(≤9 天)和 BMI 较高(≥23kg/m)相关(分别为对照组的 6.1 倍和 5.2 倍)。高血压和入住重症监护病房(ICU)是射频热凝组 SSI 的危险因素。与无 SSI 的患者相比,发生 SSI 的患者总住院费用增加了 21231 美元,住院时间延长了 7 天,术后住院时间延长了 8 天。

结论

SEEG 后行癫痫切除术的患者 SSI 发生率高于行射频热凝的患者。对于行癫痫切除术的患者,延长 SEEG 与癫痫切除术的间隔时间可降低 SSI 的风险;同时,对于行射频热凝治疗的患者,如果病情允许,不建议短期观察入住 ICU。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/584d/11282661/742a3307acee/13756_2024_1438_Fig1_HTML.jpg

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