摘要
目的分析经鼻颅底肿瘤切除术后发生颅内感染的危险因素和直接经济损失。方法选取2022年1月-6月首都医科大学附属北京天坛医院神经外科收治的经鼻颅底肿瘤切除术患者385例作为研究对象,根据患者术后是否发生颅内感染分为感染组和非感染组。多因素Logistic回归分析术后颅内感染的危险因素,以年龄和性别作为匹配因素,做1∶1匹配病例对照研究,比较感染导致的直接经济损失和住院时长。结果385例经鼻颅底肿瘤切除术患者术后共发生颅内感染33例,颅内感染率8.57%;多因素Logistic回归分析显示,脑室腹腔分流管、猪源纤维蛋白黏合剂、脑室外引流管的使用和手术时长是术后颅内感染的危险因素(P<0.05);感染组住院总费用较非感染组多19951.95元(P<0.05),各项分类费用中,中位数差值最高的是抗菌药物费,感染组抗菌药物费较非感染组多9828元(P<0.05),感染组较非感染组术后住院时间延长,住院天数(中位数)增加了5 d(P<0.05)。结论经鼻颅底肿瘤切除术患者有脑室腹腔分流管、脑室外引流管、猪源纤维蛋白黏合剂是颅内感染的危险因素,应尽量严格植入物的使用指征并尽早拔除。患者感染后直接经济损失显著,住院时间明显延长。
OBJECTIVE To investigate the risk factors for postoperative intracranial infection in the patients undergoing transnasal skull base tumor surgery and analyze the direct economic loss.METHODS Totally 385 patients who underwent transnasal skull base tumor surgery in neurosurgery department of Beijing Tiantan Hospital,Capital Medical University from Jan 2022 to Jun 2022 were recruited as the research subjects and were divided into the infection group and the non-infection group according to the status of postoperative intracranial infection.Multivariate logistic regression analysis was performed for the risk factors for the postoperative intracranial infection.A 1:1 ratio matching case-control study was conducted by taking the age and sex as the matching factors.The infection-induced direct economic loss and length of hospital stay were compared between the two groups.RESULTS Among the 385 patients who underwent the transnasal skull base tumor surgery,totally 33 had postoperative intracranial infection,with the incidence of intracranial infection 8.57%.Multivariate logistic regression analysis showed that ventriculoperitoneal shunt,porcine fibrin binder,external ventricular drainage tube and operation duration were the risk factors for the postoperative intracranial infection(P<0.05).The total hospitalization cost of the infection group was 19951.95 yuan more than that of the non-infection group(P<0.05).Among all the costs,the median difference value of the antibiotic cost was the highest,and the cost of antibiotics of the infection group was 9828 yuan more than that of the non-infection group(P<0.05).The postoperative length of hospital stay of the infection group was significantly longer than that of the non-infection group,and the medial length of hospital stay was increased by 5 days(P<0.05).CONCLUSION Ventriculoperitoneal shunt,porcine fibrin binder and external ventricular drainage tube are the risk factors for the postoperative intracranial infection in the patients undergoing transnasal skull base tumor surgery,and it is necessary to remove the implants as early as possible by strictly following the indications.The infection can lead to a significant increase of direct economic loss and extension of length of hospital stay.
作者
胡爱香
李静
于鑫玮
程实
韩玮
李储忠
张越巍
HU Ai-xiang;LI Jing;YU Xin-wei;CHENG Shi;HAN Wei;LI Chu-zhong;ZHANG Yue-wei(Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第10期1534-1538,共5页
Chinese Journal of Nosocomiology
基金
北京市自然科学基金(Z220012)。
关键词
颅底肿瘤
经鼻颅底肿瘤切除术
术后感染
神经内镜
颅内感染
危险因素
经济损失
Skull base tumor
Tansnasal skull base tumor surgery
Postoperative infection
Neuroendoscope
Intracranial infection
Risk factor
Economic loss
