国内颅脑损伤术后颅内感染危险因素的Meta分析

doi:10.3969/j.issn.1006-6233.2018.09.032

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1837 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探讨颅脑损伤术后颅内感染的危险因素,为临床治疗及预防提供理论依据。 方法: 检索中国知网、维普、万方、CBM及PubMed数据库,检索自各数据库建立始至2016年7月国内公开发表的颅脑损伤术后颅内感染的相关危险因素的病例对照研究,运用固定或随机模型对各危险因素进行定量综合分析。 结果: 共纳入14项病例对照研究,7969例研究对象。Meta分析结果示:年龄≥45岁[OR合并=1.49,95%CI(1.14~1.94),P=0.003]、术前GCS评分<8分[OR合并=2.53,95%CI(1.09~5.84),P=0.037]、血白蛋白<35g/L[OR合并=3.56,95%CI(1.27~9.96),P=0.02]、手术时间＞4h[OR合并=3.47,95%CI(1.96~6.13),P<0.0001]、放置脑室外引流[OR合并=1.93,95%CI(1.00~3.72),P<0.00001]、存在脑脊液漏[OR合并=5.15,95%CI(2.17~12.24),P=0.0002]和手术次数＞1次[OR合并=6.38,95%CI(2.72~14.97),P<0.0001]等因素均为颅脑损伤术后颅内感染的危险因素,差异均有统计学意义(P<0.05)。开放性颅脑损伤[OR合并=1.02,95%CI(0.50~2.11),P=0.95]、血糖≥7mmol/L[OR合并=3.25,95%CI(0.49~21.31),P=0.22]等因素对颅内感染的影响差异无统计学意义(P＞0.05)。 结论: 患者年龄＞45岁、术前GCS<8分、血白蛋白<35g/L、手术时间＞4h、放置脑室外引流、存在脑脊液漏及手术次数＞1次均为颅脑损伤术后颅内感染的高危险因素。指导临床对高危患者进行积极有效的预防和治疗,以降低病死率和改善预后。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：颅脑损伤, 颅内感染, 危险因素

Abstract：Objective: To explore risk factors for intracranial infection after craniocerebral injury surgery, and provided the theory basis for clinical treatment and prevention. Methods: The Chinese knowledge network, VIP, Wan Fang, CBM, and PubMed database were retrieved, and a case-control study on the related risk factors of intracranial infection after craniocerebral injury in China was retrieved from the establishment of each database to July 2016. The quantitative and comprehensive analysis of the risk factors was carried out by a fixed or random model. Results: A total of 14 case-control studies, 7969 patients had been brought into study. Meta analysis results showed that: ≥45 years old[OR_{the combineOR}=1.49,95%CI(1.14~1.94), P =0.003], preoperative GCS<8 [OR_{the combineOR}=2.53,95%CI(1.09~5.84),P=0.037], serum albumin<35g/L [OR_{the combineOR}=3.56,95%CI(1.27~9.96), P =0.02], operation time＞4 hours [OR_{the combineOR}=3.47,95%CI(1.96~6.13),P<0.0001], external ventricular drainage [OR_{the combineOR}=1.93,95%CI(1.00~3.72), P<0.00001], cerebrospinal fluid leakage [OR_{the combineOR}=5.15,95%CI(2.17~12.24), P=0.0002] and operation more than once were all risk factors for intracranial infection after craniocerebral injury surgery, the difference has statistically significance (P<0.05). The influence factor of open craniocerebral injury [OR_{the combineOR}=1.02, 95%CI(0.50~2.11),P=0.95], blood glucose≥7mmol/L [OR_{the combineOR}=3.25, 95%CI(0.49~21.31), P=0.22] has no statistically significance(P＞0.05). Conclusion: The age was≥45 years old, GCS<8, ALB<35g/L, operation time＞4 hours, external ventricular drainage, cerebrospinal fluid leakage, operation more than once were high risk factors for intracranial infection after craniocerebral injury surgery. Positive prevention and treatment should be carried on the clinical guidance for high-risk patients to reduce mortality and improve prognosis.

Key words： Craniocerebral injury Intracranial infection Risk factors

基金资助:2016年度河北省医学科学研究重点课题计划指令性课题,(编号:20160013)

通讯作者: 王维兴

引用本文:

王昆鹏, 王维兴, 杨婕, 呼铁民, 闫丽娜. 国内颅脑损伤术后颅内感染危险因素的Meta分析[J]. 河北医学, 2018, 24(9): 1527-1531.
WANG Kunpeng, WANG Weixing, YANG Jie, et al. Meta Analysis of Risk Factors for Intracranial Infection after Craniocerebral Injury in China. HeBei Med, 2018, 24(9): 1527-1531.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.09.032 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I9/1527

[1] 王忠安,黎开谷,刘金辉,等.重型颅脑损伤患者手术后颅内感染相关因素临床分析[J].中华医院感染学杂志,2013,23(16):3903~3905.
[2] Kono Y, Prevedello DM, Snyderman CH. One thousand endoscopic skull base surgical procedures demystifying the infection potential: incidence and description of postoperative meningtis and brain abscesses[J].Infect Control Hosp Epidemiol, 2011,32(1):77~83.
[3] 宋歌,李奇.急性闭合性颅脑损伤术后颅内感染相关危险因素分析[J].陕西医学杂志,2013,42(9):1165~1167.
[4] 谢贤生,刘胜初,张显强.47例颅脑外伤术后颅内感染的相关危险因素分析[J].赣南医学院学　报,33(6):848~850.
[5] 武霄峰,侯林.颅脑外伤术后颅内感染的危险因素分析及干预对策[J].中国医药导刊,2013,15(9):1549~1550.
[6] 马金福.闭合性颅脑损伤术后颅内感染的相关因素分析[J].中西医结合心血管病杂志,2015,3(32):91~92.
[7] 何林.探究颅脑外伤术后颅内感染相关危险因素[J].医学信息,2015,28(38):257~258.
[8] 李建峰,崔凯,董亚兰.急性颅脑损伤患者术后颅内感染相关因素临床分析[J].中国现代医学杂志,2014,24(17):87~89.
[9] 陈飞宇,陈光烈,任浩君,等.颅脑外伤患者开颅术后颅内感染的相关因素与耐药性分析[J].中华医院感染学杂志,2016,26(4):799~801.
[10] Chao Lin,Xin Zhao.Haichen Sun. Analysis on the risk factors of intracranial infection secondary to traumatic brain lnjury[J]. Chinese Journal of Traumatology, 2015,18(2):81~83.
[11] 孙虎.颅脑外伤术后颅内感染相关危险因素分析[J].中华医院感染学杂志,2013,23(1):65~67.
[12] 罗文韬,张勇,曹成安,等.脑外伤术后发生颅内感染的相关因素探讨[J].国际医药卫生导报,2015,21(6):778~780.
[13] 李玉伟,雷燕妮,陈必耀,等.闭合性重度颅脑损伤患者开颅术后颅内感染相关因素分析及对策[J].临床神经外科杂志,2015,12(4):253~255.
[14] 林进平,杨绮帆,钱锁开.颅脑外伤术后颅内感染相关因素分析[J].现代诊断与治疗,20l0,21(3):143~145.
[15] HU Shen, YANG Jia-yong, WEI Xue-zhong, etc. Analysis of risk factors of affecting intracranial infection complicating brain injury operation[J]. Chin Neuromed, 2006,5(5) 498~502.
[16] 于晓晨,张永辉,林琳.神经外科术后颅内感染的危险因素分析[J].中国实用神经疾病杂志,2017,20(11):27~29.