摘要
目的探究成年脑积水患者脑室腹腔分流术后颅内感染的危险因素,为其早期预测和临床防治提供参考。方法回顾性分析2014年1月至2019年6月徐州医科大学附属医院收治的282例接受脑室腹腔分流术的脑积水患者临床资料。记录患者颅内感染的发生率,分析引起感染的病原菌。采用单因素及多因素Logistic回归分析发生颅内感染的危险因素。结果本研究中颅内感染患者37例,感染率为13.1%;脑脊液细菌培养中革兰氏阳性菌为57.1%,革兰氏阴性菌为38.8%。单因素分析显示,年龄、脑积水病因、格拉斯哥昏迷(GCS)评分、高血糖、气管切开史、腹部手术史、切口脑脊液漏、置管时间是成年脑积水患者脑室腹腔分流术后发生颅内感染的影响因素(P<0.05);多因素Logistic回归分析结果显示,自发性脑出血、高血糖、切口脑脊液漏、置管时间<3个月是成年脑积水患者脑室腹腔分流术后发生颅内感染的独立危险因素。结论自发性脑出血、高血糖、切口脑脊液漏、置管时间<3个月与颅内感染发生率显著相关,对伴有以上危险因素的患者应予以高度重视,积极控制干预,以降低颅内感染发生率。
Objective To investigate the risk factors of intracranial infection after ventriculoperitoneal shunt in adults with hydrocephalus,and to provide reference for early prediction and clinical prevention.Methods The clinical data of 282 patients with hydrocephalus who received ventriculoperitoneal shunt in the Affiliated Hospital of Xuzhou Medical University from January 2014 to June 2019 were analyzed retrospectively.The incidence of intracranial infection was recorded and the pathogenic bacteria causing the infection were analyzed.Univariate and multivariate Logistic regression were used to analyze the risk factors for intracranial infection.Results There were 37 patients with intracranial infection,and the incidence was 13.1%.Gram-positive bacteria and Gram-negative bacteria in CSF culture were 57.1%and 38.8%respectively.Univariate analysis showed that the age,etiology of hydrocephalus,Glasgow coma scale(GCS)score,hyperglycemia,history of tracheotomy,history of abdominal surgery,leakage of incision cerebrospinal fluid,and catheterization time were the influencing factors of intracranial infection after ventriculoperitoneal shunt in adults with hydrocephalus(P<0.05).Multivariate Logistic regression analysis showed that spontaneous intracerebral hemorrhage,hyperglycemia,leakage of incision cerebrospinal fluid,and catheterization time<3 months were the independent risk factors for intracranial infection after ventriculoperitoneal shunt in adults with hydrocephalus.Conclusion Spontaneous intracerebral hemorrhage,hyperglycemia,leakage of incision cerebrospinal fluid,and catheterization time<3 months are significantly related to the incidence of intracranial infection.Patients with the above risk factors should be attached great importance to actively control and intervene to reduce the incidence of intracranial infection.
作者
杨晗
韩宇涵
陈雨清
路洋
张永康
于如同
YANG Han;HAN Yu-han;CHEN Yu-qing;LU Yang;ZHANG Yong-kang;YU Ru-tong(Department of Neurosurgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221002,China;Department of Ultrasound Imaging,Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221002,China)
出处
《局解手术学杂志》
2020年第11期866-870,共5页
Journal of Regional Anatomy and Operative Surgery
基金
国家自然科学基金(81772665)。
关键词
脑积水
脑室腹腔分流术
颅内感染
危险因素
hydrocephalus
ventriculoperitoneal shunt
intracranial infection
risk factors
