经鼻内镜下脑脊液鼻漏修补术后颅内感染因素分析
Postoperative intracranial infection factor analysis of repair ofcerebrospinal fluid rhinorrhea under nasal endoscope
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摘要: 目的 观察分析经鼻内镜下脑脊液鼻漏修补术后颅内感染因素,为预防控制感染提供数据支持。方法 选取2012年9月-2015年9月在医院通过手术治疗182例脑脊液鼻漏患者为研究对象,分析脑脊液的病原菌培养结果以及引发术后颅内感染的主要危险因素。结果 182例患者中有20例术后引发颅内感染,感染率为10.99%;脑脊液的病原菌培养结果检出26株病原菌,其中金黄色葡萄球菌最多10株,占38.46%;漏口大小>1 cm,有既往颅内感染史以及手术修补失败患者术后颅内感染率高;logistic回归分析法危险因素分析发现,漏口大小>1 cm,既往有颅内感染史以及手术修补失败均是患者术后颅内感染的主要危险因素。结论 经鼻内镜辅助下脑脊液鼻漏修补手术后并发颅内感染的危险因素较多,临床上应加以重视。Abstract: OBJECTIVE To observe and analyze postoperative intracranial infection factors of repair of cerebrospinal fluid rhinorrhea under nasal endoscope,so as to provide data support for the prevention and control of infection.METHODS A total of 182 cases of cerebrospinal fluid rhinorrhea patients in the hospital with the surgery treatment from Sept.2012 to Sep.2015 were selected as the research objects,culture results of pathogens in cerebrospinal fluid and the main risk factors for postoperative intracranial infection were analyzed.RESULTS Totally 20 cases of intracranial infections occurred in 182 cases of patients,with the infection rate of 10.99%.Totally 26 strains of pathogenic bacteria were detected in culture results of cerebrospinal fluid,and Staphylococcus aureus was the most,with 10 strains,accounting for 38.46%.The patients with leak size>1cm,previous history of intracranial infection,and surgical repair failure had high postoperative intracranial infection rate.The logistic regression analysis for risk factors found that leak size> 1cm,previous history of intracranial infection,and surgical repair failure were the main risk factors of postoperative intracranial infections.CONCLUSION Repair operation of cerebrospinal fluid rhinorrhea under nasal endoscope has many risk factors of postoperative intracranial infections,so attention should be paid to the clinical.
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