Liu Yufeng, Liu Jie, Wu Xiaoyan, Jiang Enshe
Department of Cardiovascular Medicine, Luoyang Central Hospital affiliated to Zhengzhou University, Luoyang, Henan, 471000, People's Republic of China.
Department of Neurosurgery, The First Affiliated Hospital of Henan University, Kaifeng, Henan, 475004, People's Republic of China.
J Multidiscip Healthc. 2024 Jul 29;17:3637-3648. doi: 10.2147/JMDH.S476125. eCollection 2024.
The central nervous system (CNS) is less prone to infection owing to protection from the brain-blood barrier. However, craniotomy destroys this protection and increases the risk of infection in the brain of patients who have undergone craniotomy. CNS infection after craniotomy significantly increases the patient's mortality rate and disability. Controlling the occurrence of intracranial infection is very important for post-craniotomy patients. CNS infection after craniotomy is caused by several factors such as preoperative, intraoperative, and post-operative factors. Craniotomy may lead to postsurgical intracranial infection, which is mainly associated with surgery duration, infratentorial (posterior fossa) surgery, cerebrospinal fluid leakage, drainage tube placement, unregulated use of antibiotics, glucocorticoid use, age, diabetes, and other systemic infections. Understanding the risk factors of CNS infection after craniotomy can benefit reducing the incidence of intracranial infectious diseases. This will also provide the necessary guidance and evidence in clinical practice for planning to control intracranial infection in patients with craniotomy.
由于血脑屏障的保护作用,中枢神经系统(CNS)不易受到感染。然而,开颅手术会破坏这种保护,增加接受开颅手术患者脑部感染的风险。开颅术后的中枢神经系统感染会显著提高患者的死亡率和致残率。控制颅内感染的发生对于开颅术后患者非常重要。开颅术后的中枢神经系统感染由多种因素引起,如术前、术中和术后因素。开颅手术可能导致术后颅内感染,这主要与手术时长、幕下(后颅窝)手术、脑脊液漏、引流管放置、抗生素使用不当、糖皮质激素使用、年龄、糖尿病及其他全身感染有关。了解开颅术后中枢神经系统感染的危险因素有助于降低颅内感染性疾病的发生率。这也将为临床实践中计划控制开颅手术患者的颅内感染提供必要的指导和依据。