目的探讨颅脑手术后患者发生医院感染的相关危险因素,并对相应的干预措施进行研究,为临床防治提供参考依据。方法收集2008年1月-2012年12月入住神经外科的820例患者临床资料,应用多因素分析发生感染的相关危险因素。结果820例颅脑手术患者中发生医院感染128例,感染率为15.61%,感染部位以呼吸系统为主,占66.41%;糖尿病史、吸烟史、侵入性操作、抗菌药物预防使用与颅脑手术后患者医院感染发生存在密切相关性,其感染率分别为24.48%、23.81%、21.43%、26.34%;多因素分析显示,既往存在糖尿病史、吸烟史,手术及住院时间的延长、手术存在侵入性操作是颅脑手术后医院感染发生的独立危险因素(P〈0.05)。结论颅脑手术后医院感染的发生与糖尿病史、吸烟史,手术及住院时间的延长、手术存在侵入性操作有密切相关性,是其发生医院感染的独立危险因素,在临床工作中对于上述可干预因素进行必要的干预,可降低医院感染的发生风险。
OBJECTIVE To analyze the related factors of nosocomial infection in patients with craniocerebral operations, provides the reference basis for the clinical prevention and treatment. METHODS The clinical data of 820 patients admitted to the department of neurosurgery from Jan 2008 to Dec 2012 were collected, and the related risk factors for infection were analyzed by multiple factors analysis. RESULTS Among 820 patients with craniocerebral surgery, nosocomial infection occurred in 128 patients, and the incidence of infection was 15.6%. Respiratory tract was the main infection site, accounting for 66.41%. Diabetes history, smoking history, invasive operation, prevention use of antibiotics were closely related with hospital infection after craniocerebral operations, and the infection rates were 24. 48%, 23.81%, 21.43%, 26.34% respectively. Multiple factor analysis showed that diabetes history, smoking history, operation time and hospitalization time, invasive operation were independent risk factors for nosocomial infections after craniocerebral operation (P〈 0. 05). CONCLUSION Diabetes history, smoking history, operation time and hospitalization time, invasive operation are closely related with occurrence of nosocomial infections after craniocerebral operation as independent risk factors. Intervention of these factors may reduce the risks of the occurrence of nosocomial infections