摘要
目的 颅内感染是神经外科手术术后的常见并发症,本研究旨在调查开颅手术患者术后发生颅内感染的高危因素.方法 回顾性选取 313 例开颅手术患者并收集其临床资料,通过t检验、卡方检验、logstic回归对开颅手术患者术后颅内感染的危险因素进行分析,并通过孟德尔随机化对危险因素进行验证.结果 313 例开颅手术患者中31例(9.90%)出现术后颅内感染.卡方检验结果显示,术后使用激素、术前ASA 3-4 级、接台手术、手术时长大于3 小时、病变部位位于幕下为术后颅内感染的危险因素.logstic回归模型包括激素使用情况、ASA分级、是否接台手术、手术时长,模型的曲线下面积为 0.733,具有较好的预测能力.孟德尔随机化结果验证使用激素是术后感染的高危因素.结论 术后使用激素、术前ASA 3-4 级、接台手术、手术时长大于 3 小时为开颅手术后颅内感染的危险因素.
Abstract
Objective Intracranial infection is a common complication after neurosurgery.This study aims to investigate the high-risk factors for intracranial infection in patients undergoing craniotomy.Methods This study retrospectively selected 313 patients with craniotomy surgery and collected their clinical data.The risk factors for postoperative intracranial infection in patients with craniotomy surgery were analyzed through t test,chi-square test,and logstic regression,and Mendelian randomization was used to analyze verify the risk factors.Results Among 313 patients undergoing craniotomy,31(9.90%)developed intracranial infection after surgery.The results of the chi-square test showed that postoperative steroid use,preoperative ASA grade 3-4,consecutive operation,more than 3 hours length of surgery,and the location of the lesion in the infratentorial area were risk factors for postoperative intracranial infection.The logstic regression model included steroid use,ASA classification,whether it was a consecutive operation,and length of surgery.the model had a good predictive ability with an area under the curve of 0.733.Mendelian randomization results confirmed that the use of steroids was a high-risk factor for postoperative infection.Conclusions Postoperative steroid use,preoperative ASA grade 3-4,consecutive operation,and more than 3 hours length of surgery are risk factors for intracranial infection after craniotomy.
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