摘要
目的分析颅内压监测探头植入及侧脑室引流脑室出血患者颅内感染的危险因素。方法回顾性分析2019年1月-2020年12月上海交通大学医学院附属苏州九龙医院收治的188例侧脑室引流及颅内压探头植入的脑室出血患者的临床资料,依据患者是否发生颅内感染分为感染组31例和非感染组157例。分析颅内压监测探头植入及侧脑室引流患者颅内感染病原菌分布情况,探究颅内压监测探头植入及侧脑室引流脑室出血患者颅内感染的危险因素。结果感染组患者年龄≥60岁、非脑挫裂伤灶或出血点、血糖>6.11 mmol/L、INR>1.2、血小板计数<80×10^(9)/L、术前格拉斯哥昏迷指数(GCS)评分≤8分、脑脊液漏、手术时间≥4 h、锥颅置入探头、双侧引流、引流留置时间≥8 d、导管口护理≥2次/d占比高于非感染组(P<0.05)。多因素Logistic回归分析显示,GCS评分≤8分、脑脊液漏为颅内压监测探头植入及侧脑室引流脑室出血患者颅内感染的危险因素(P<0.05)。结论颅内压监测探头植入及侧脑室引流脑室出血患者颅内感染病原菌以金黄色葡萄球菌和凝固酶阴性葡萄球菌为主,其发生与GCS评分、脑脊液漏相关。
OBJECTIVE To investigate the risk factors for intracranial infection in ventricular hemorrhage patients with implantation of intracranial pressure monitoring probe and lateral ventricle drainage.METHODS A total of 188 ventricular hemorrhage patients who underwent lateral ventricle drainage and implantation of intracranial pressure monitoring probe in Suzhou Jiulong Hospital of Shanghai Jiao Tong University School of Medicine from Jan 2019 to Dec 2020 were enrolled in the study,the clinical data of the patients were retrospectively analyzed,the enrolled patients were divided into the infection group with 31 cases and the no infection group with 157 cases according to the status of intracranial infection.The distribution of pathogens causing the intracranial infection in the patients with implantation of intracranial pressure monitoring probe and lateral ventricle drainage was observed,and the risk factors for the intracranial infection in the ventricular hemorrhage patients were explored.RESULTS The proportions of patients with no less than 60 years of age,non-cerebral contusion and laceration lesion or bleeding point,blood glucose more than 6.11 mmol/L,INR more than 1.2,blood platelet count less than 80×10^(9)/L,preoperative Glasgow coma scale(GCS)score no more than 8 points,leakage of cerebrospinal fluid,operation duration no less than 4 hours,cranial drilling probe,bilateral drainage,drainage indwelling time no less than 8 days and care of catheter port no less than 2 times a day were significantly higher in the infection group than in the no infection group(P<0.05).Multivariate logistic regression analysis showed that GCS score no more than 8 points and leakage of cerebrospinal fluid were the risk factors for the intracranial infection in the ventricular hemorrhage patients with implantation of intracranial pressure monitoring probe and lateral ventricle drainage(P<0.05).CONCLUSION Staphylococcus aureus and coagulase-negative Staphylococcus are dominant among the pathogens causing intracranial infection in the ventricular hemorrhage patients with implantation of intracranial pressure monitoring probe and lateral ventricle drainage,and the incidence of intracranial infection is associated with GCS score and leakage of cerebrospinal fluid.
作者
王冕
沈李奎
周强
周世军
王安琪
孟璇
蒋栋毅
WANG Mian;SHEN Li-kui;ZHOU Qiang;ZHOU Shi-jun;WANG An-qi;MENG Xuan;JIANG Dong-yi(Suzhou Jiulong Hospital of Shanghai Jiao Tong University School of Medicine,Suzhou,Jiangsu215000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第17期2624-2627,共4页
Chinese Journal of Nosocomiology
关键词
侧脑室引流
颅内压监测
探头植入
颅内感染
危险因素
Lateral ventricle drainage
Intracranial pressure monitoring
Probe implantation
Intracranial infection
Risk factor
