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脑室外引流感染的相关危险因素分析

王红军   

  1. 青海省交通医院
  • 收稿日期:2013-01-21 修回日期:2013-08-29 出版日期:2014-01-15 发布日期:2014-01-15
  • 通讯作者: 王红军

Nosocomial Infection in Patients Cured by Ventricle Drainage: An Analysis of 228 Cases

  • Received:2013-01-21 Revised:2013-08-29 Published:2014-01-15 Online:2014-01-15

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摘要： 目的 分析影响脑室外引流 （EVD） 术后感染的相关因素， 以降低术后感染率。方法 选取228例行EVD手术的患者， 其中脑脊液 （CSF） 感染组53例， 未感染组175例， 比较2组的相关资料， 分析EVD术后感染的影响因素。结果 CSF感染组的CSF渗漏比例 （18.9%）、 后颅窝手术比例 （41.5%） 及导管置留时间 （13.7±10.7） d高于未感染组， 分别为8.6%、 20%及 （6.4±7.5） d， 但CSF采样次数 （1.4 ±1.8） 次低于未感染组 （4.0±3.7） 次， 差异均有统计学意义；导管置留时间>11 d、 有CSF渗漏是CSF感染的危险因素， CSF采样次数<1次是保护因素。结论 EVD相关感染与引流时间、 频繁的CSF采样、 脑脊液漏有关。

关键词: 脑室外引流, 感染, 指征

Abstract: Abstract Objective The purpose of the present retrospective single centre study is to assess the possible causes of these infections. Patients and methods Two hundred and twenty-eight patients were included in the period from January 2003 until April 2011. Patient and disease demographics,as well as EVD data, and the occurrence of infection were reviewed, compared, and included in a risk-analysis study.Results The population's mean age was 56士15 years and the sexes were equally distributed. Most frequently,the indication for EVD was hydrocephalus due to in-traventricular haemorrhage (48.2%).An infection was documented in 23.2% of all patients.Duration of EVD drainage appeared to be a risk factor for infection(>11 days: OR 4.1;95% CI 1.8一9.2, p=0.001).CSF sampling frequency was also a significant risk-factor (no sampling: OR 0.2, 95% CI 0.2-0.5, p=0.003).Conclusions We found a relatively high percentage of EVD-related infections.After multivariate analysis there appears to be a relation with duration of drainage，frequent CSF sampling and cerebrospinal fluid leakage.As a result, a new EVD protocol is proposed in our institution that we believe will decrease the number of EVD-related infections to a minimum.

Key words: External ventricular drainage, central nervous system infection, protocol.