摘要
目的调查颅内动脉瘤术后合并颅内感染的危险因素及病原菌分布情况,并采取相应的预防干预措施。方法纳入2015年至2020年利津县中医院行颅内动脉瘤手术患者198例,其中男98例、女100例,年龄(46.68±1.06)岁。将出现颅内感染的患者作为发生组,未发生颅内感染的患者作为未发生组,将基本信息和临床资料进行对比,并筛选差异有统计学意义的自变量进行多因素logistic回归分析。结果198例颅内动脉瘤手术患者中39例出现颅内感染,发生率为19.70%。单因素分析显示,合并糖尿病、手术时间≥4 h、术中动脉瘤破裂、术中出血≥100 ml、术中脑脊液漏、引流管留置时间≥7 d、气管切开、糖皮质激素应用及意识障碍均是颅内感染发生的相关因素(均P<0.05)。多因素logistic回归分析显示,手术时间≥4 h(OR=2.048,95%CI:1.008~4.164,P=0.019)、术中脑脊液漏(OR=2.328,95%CI:1.000~5.418,P=0.032)及引流管留置时间≥7 d(OR=2.365,95%CI:1.227~4.561,P=0.006)均是颅内感染发生的独立危险因素。检测病原菌共178株,革兰阴性菌89株(50.00%)、革兰阳性菌68株(38.20%)、真菌21株(11.80%),其中主要细菌为铜绿假单胞菌[38株(21.35%)]、金黄葡萄球菌[36株(20.22%)]、大肠埃希菌[31株(17.42%)]。结论本次研究手术时间≥4 h、术中脑脊液漏及引流管留置时间≥7 d均为颅内动脉瘤术后合并颅内感染发生的重要因素,临床应提高对上述因素的重视,提高护理质量,采取相应预防干预措施,减少治疗中颅内感染的发生。
Objective To investigate the risk factors of intracranial infection and the distribution of pathogenic bacteria after intracranial aneurysm operation,and to take appropriate preventive measures.Methods There were 198 cases of intracranial aneurysm operation in Lijin County Hospital of Traditional Chinese Medicine from 2015 to 2020,including 98 males and 100 females,with an age of(46.68±1.06)years old.Patients with intracranial infection after intracranial aneurysm operation were set as an infection group,and patients without intracranial infection as a non-infection group.The basic information and clinical data were compared,and independent variables with statistically significant differences were screened out for multivariate logistic regression analysis.Results There were 39 cases of intracranial infection in 198 cases,with an incidence of 19.70%.Univariate analysis showed that diabetes mellitus,operation time≥4 h,rupture of aneurysms during the operation,bleeding during the operation≥100 ml,cerebrospinal fluid leakage,indwelling time of drainage tube≥7 days,tracheotomy,hormone application,and disturbance of consciousness were all related factors(all P<0.05).Multivariate logistic regression analysis showed that operation time≥4 h(OR=2.048,95%CI:1.008-4.164,P=0.019),cerebrospinal fluid leakage(OR=2.328,95%CI:1.000-5.418,P=0.032),and indwelling time of drainage tube≥7 days(OR=2.365,95%CI:1.227-4.561,P=0.006)were independent risk factors for intracranial infection.A total of 178 strains of pathogens were detected,including 89 strains of gram-negative bacteria(50.00%),68 strains of gram-positive bacteria(38.20%),and 21 strains of fungi(11.80%).The main bacteria were Pseudomonas aeruginosa[38 strains(21.35%)],Staphylococcus aureus[36 strains(20.22%)],and Escherichia coli[31 strains(17.42%)].Conclusions Operation time≥4 h,intraoperative cerebrospinal fluid leakage,and indwelling time of drainage tube≥7 days are the important factors of intracranial infection after intracranial aneurysm operation.We should pay more attention to these factors,improve the quality of nursing care,and take appropriate preventive intervention measures to reduce the incidence of intracranial infection in the treatment.
作者
郭立梅
Guo Limei(Lijin County Hospital of Traditional Chinese Medicine,Dongying 257447,China)
出处
《国际医药卫生导报》
2021年第16期2619-2622,共4页
International Medicine and Health Guidance News
关键词
颅内动脉瘤
手术
颅内感染
病原菌分布
预防干预
Intracranial aneurysm
Surgery
Intracranial infection
Distribution of pathogenic bacteria
Preventive intervention
