经鼻颅底肿瘤切除术后颅内感染危险因素与直接经济损失
Risk factors for postoperative intracranial infection in patients undergoing transnasal skull base tumor surgery and direct economic loss
胡爱香 1李静 1于鑫玮 1程实 1韩玮 1李储忠 2张越巍1
作者信息
- 1. 首都医科大学附属北京天坛医院感染管理处,北京 100070
- 2. 首都医科大学附属北京天坛医院神经外科学中心,北京 100070
- 折叠
摘要
目的 分析经鼻颅底肿瘤切除术后发生颅内感染的危险因素和直接经济损失.方法 选取2022年1月-6月首都医科大学附属北京天坛医院神经外科收治的经鼻颅底肿瘤切除术患者385例作为研究对象,根据患者术后是否发生颅内感染分为感染组和非感染组.多因素Logistic回归分析术后颅内感染的危险因素,以年龄和性别作为匹配因素,做1∶1匹配病例对照研究,比较感染导致的直接经济损失和住院时长.结果 385例经鼻颅底肿瘤切除术患者术后共发生颅内感染33例,颅内感染率8.57％;多因素Logistic回归分析显示,脑室腹腔分流管、猪源纤维蛋白黏合剂、脑室外引流管的使用和手术时长是术后颅内感染的危险因素(P＜0.05);感染组住院总费用较非感染组多19 951.95元(P＜0.05),各项分类费用中,中位数差值最高的是抗菌药物费,感染组抗菌药物费较非感染组多9 828元(P＜0.05),感染组较非感染组术后住院时间延长,住院天数(中位数)增加了 5 d(P＜0.05).结论 经鼻颅底肿瘤切除术患者有脑室腹腔分流管、脑室外引流管、猪源纤维蛋白黏合剂是颅内感染的危险因素,应尽量严格植入物的使用指征并尽早拔除.患者感染后直接经济损失显著,住院时间明显延长.
Abstract
OBJECTIVE To investigate the risk factors for postoperative intracranial infection in the patients under-going transnasal skull base tumor surgery and analyze the direct economic loss.METHODS Totally 385 patients who underwent transnasal skull base tumor surgery in neurosurgery department of Beijing Tiantan Hospital,Cap-ital Medical University from Jan 2022 to Jun 2022 were recruited as the research subjects and were divided into the infection group and the non-infection group according to the status of postoperative intracranial infection.Multiva-riate logistic regression analysis was performed for the risk factors for the postoperative intracranial infection.A 1∶1 ratio matching case-control study was conducted by taking the age and sex as the matching factors.The infec-tion-induced direct economic loss and length of hospital stay were compared between the two groups.RESULTS A-mong the 385 patients who underwent the transnasal skull base tumor surgery,totally 33 had postoperative in-tracranial infection,with the incidence of intracranial infection 8.57％.Multivariate logistic regression analysis showed that ventriculoperitoneal shunt,porcine fibrin binder,external ventricular drainage tube and operation du-ration were the risk factors for the postoperative intracranial infection(P＜0.05).The total hospitalization cost of the infection group was 19951.95 yuan more than that of the non-infection group(P＜0.05).Among all the costs,the median difference value of the antibiotic cost was the highest,and the cost of antibiotics of the infection group was 9828 yuan more than that of the non-infection group(P＜0.05).The postoperative length of hospital stay of the infection group was significantly longer than that of the non-infection group,and the medial length of hospital stay was increased by 5 days(P＜0.05).CONCLUSION Ventriculoperitoneal shunt,porcine fibrin binder and ex-ternal ventricular drainage tube are the risk factors for the postoperative intracranial infection in the patients under-going transnasal skull base tumor surgery,and it is necessary to remove the implants as early as possible by strict-ly following the indications.The infection can lead to a significant increase of direct economic loss and extension of length of hospital stay.
关键词
颅底肿瘤/经鼻颅底肿瘤切除术/术后感染/神经内镜/颅内感染/危险因素/经济损失Key words
Skull base tumor/Tansnasal skull base tumor surgery/Postoperative infection/Neuroendoscope/In-tracranial infection/Risk factor/Economic loss引用本文复制引用
出版年
2024
NETL
NSTL
万方数据