中文摘要：

目的：探讨颅脑术后严重颅内感染患者脑脊液病原菌分布与其治疗效果的影响，为术后颅内感染的预防、诊治及控制提供临床依据。方法选取医院2011年1月－2015年1月56例开颅术后脑脊液培养阳性的颅内感染患者，分析病原菌分布和治疗效果。结果56例颅内感染患者脑脊液标本培养分离到病原菌68株，包括革兰阳性菌43株、革兰阴性菌22株、真菌3株，分别占63．24％、32．35％和4．41％；单菌种感染44例、多菌混合感染12例，分别占78．57％和21．43％；26例鞘内灌洗患者治愈14例，30例脑室内灌洗患者治愈24例；GCS评分、再次手术、其他部位感染、混合感染、手术方式和手术时间是影响颅内感染患者疗效的独立危险因素（P＜0．05）。结论颅内感染患者革兰阳性菌检出率高于革兰阴性菌，治疗时应根据药敏试验结果进行，脑室灌洗治愈率明显优于鞘内灌洗治愈率，混合感染患者预后较差。

英文摘要：

OBJECTIVE To investigate the bacterial distribution of cerebrospinal fluid cultures and its effect on cura‐tive outcome for patients undergoing craniotomy with intracranial infections ,so as to provide guideline for preven‐ting ,treatment and controlling of intracranial infections .METHODS A total of 56 cases of patients in our hospital from Jan 2011 to Jan 2015 with positive cerebrospinal fluid cultures were chosen and their pathogenic distribution and therapeutic effect were analyzed .RESULTS In 56 cases of cerebrospinal fluid cultures ,68 strains of pathogenic bacteria were isolated ,including 43 strains of gram‐positive bacteria ,22 strains of gram negative bacteria ,and 3 strains of fungi ,accounting for 63 .24% ,32 .25% and 4 .41% respectively .There were 44 cases of patients with single infection and 12 cases patients with multi‐infections ,accounting for 78 .57% and 21 .43% .There were 14 cases of cured patients in 26 cases who received intrathecal irrigation .And there were 24 cases of cured patients in 30 cases who received intraventricular lavage .GCS score ,reoperation ,infection at other places ,mixed infection , operation method and operation duration were independent risk factors for curative outcome for patients undergo‐ing craniotomy with intracranial infection （P〈0 .05） .CONCLUSION The gram‐positive bacteria detection rate was significantly higher than that of gram negative bacteria .Treatments should comply with the drug sensitive test . The cured rate of patients with ventricular irrigation was higher than that of patients with intrathecal irrigation . Patients with mixed infection showed bad prognosis .