颅内肿瘤术后合并颅内感染的防治.docVIP

颅内肿瘤术后合并颅内感染的防治 　　摘要：目的 探讨颅内肿瘤术后合并颅内感染的防治措施与效果。方法 在2014年1月～2016年1月选取我院收治的158例颅内肿瘤手术的患者，其中术后合并颅内感染的患者有9例，对其临床资料进行回顾性分析。结果 颅内肿瘤术后合并颅内感染的主要因素包括手术时间超过4h、引流管留置时间超过48h、幕下手术与脑脊液渗漏，而术前预防性的使用抗生素治疗能够显著降低术后颅内感染的发生率。所有患者通过脑脊液培养，其中凝固酶阴性葡萄球菌4例（2.5%）；铜绿假单孢菌3例（1.8%）；金黄色葡萄球菌1例（0.6%）；大肠挨希菌1例（0.6%）。通过抗生素治疗后，治愈7例，2例死亡，病死率为22.2%。结论 颅内肿瘤术后合并颅内感染的主要诱发因素包括手术时间超过4h，引流管留置时间超过48h，术后脑脊液渗漏，幕下手术等。针对该类并发症，需要在术前进行有效的预防，采用抗生素降低颅内感染的发生。同时，全身与鞘内注射联合应用敏感抗生素可以有效的控制颅内感染，对患者的预后具有较大的改善作用。 　　关键词：颅内肿瘤术；合并；颅内感染；防治 　　Abstract：Objective Explore postoperative intracranial tumor with intracranial infection prevention and control measures and effect.Methods In January 2014 to January 2016， during the selection of our hospital， 158 cases of patients with intracranial tumor surgery， postoperative intracranial infection combined with 9 cases， the clinical data were retrospectively analyzed.Results The main factors of intracranial tumor were complicated by intracranial infection including operation time more than 4 hours， drainage tube indwelling time more than 48 hours， tentorium surgery and cerebrospinal fluid leakage， and preoperative prophylactic use of antibiotics treatment can significantly reduce the incidence of postoperative intracranial infection. All of the patients with CSF cultures， among them 4 cases were coagulase negative staphylococcus， 2.5%； Verdigris false single spore fungus （3 cases）， accounting for 1.8%； Staphylococcus aureus， 1 case （0.6%）， E. get bacteria in 1 case， accounted for 0.6%. Cured with antibiotics treatment， 7 cases， 2 cases of death， the case fatality rate of 22.2%.Conclusion Intracranial tumor surgery combined the main inducing factors of intracranial infection including operation time more than 4 hours， drainage tube indwelling time more than 48 hours， postoperative cerebrospinal fluid leakage， the tent of meeting under operation， etc. For such complications， need for effective prevention before surgery， the use of antibiotics to reduce the occurrence of intracranial infec