Rotim K, Miklic P, Paladino J, Melada A, Marcikic M, Scap M
Department of Neurosurgery, KBC Zagreb, Croatia.
Childs Nerv Syst. 1997 Nov-Dec;13(11-12):584-7. doi: 10.1007/s003810050144.
We reviewed our experience with shunt implantation during two time periods. From June 1985 to December 1990, 201 children with hydrocephalus underwent 382 operations. Among these children 36 (18%) developed a proven shunt infection, with an incidence rate per procedure of 9.4%. As a result of this study, a new effective protocol for shunt procedures involving modifications to the perioperative (antibiotic prophylaxis) and intraoperative management (meticulous surgical technique, complete shunt revision) of children undergoing initial shunt implantation or revision was initiated. With this new protocol 75 children underwent a total of 112 procedures between January 1991 and December 1995. The incidence of shunt infection decreased, with a per patient rate of 8% and a per procedure rate of 5.3%. The majority of infections in our study were caused by Staphylococcus epidermidis, which was found in 22 (52.3%) patients.
我们回顾了两个时间段内进行分流植入手术的经验。1985年6月至1990年12月，201名脑积水患儿接受了382次手术。在这些患儿中，36例（18%）发生了经证实的分流感染，每次手术的感染发生率为9.4%。这项研究的结果促使我们启动了一项新的有效方案，该方案涉及对初次分流植入或翻修手术患儿的围手术期（抗生素预防）和术中管理（精细的手术技术、彻底的分流翻修）进行改进。采用这一新方案后，在1991年1月至1995年12月期间，75名患儿共接受了112次手术。分流感染发生率有所下降，每位患者的感染率为8%，每次手术的感染率为5.3%。我们研究中的大多数感染是由表皮葡萄球菌引起的，22例（52.3%）患者中发现了该菌。
