早期颅骨修补并脑室—腹腔分流术和分期单项手术术后感染相关因素研究.docVIP

早期颅骨修补并脑室—腹腔分流术和分期单项手术术后感染相关因素研究【摘要】 目的：探讨同期颅骨修补合并脑室—腹腔分流术与分期单项手术致颅内感染率有无差异，分析引起感染的相关因素，提出防治策略。方法：分别对16例脑积水合并颅骨缺损患者行颅骨修补术合并脑室—腹腔分流术，15例分期行颅骨修补。并对分流手术术后感染的相关资料进行回顾分析。结果：同期手术16例，术后半年内感染7例，其中颅内感染4例（1例死亡），切口感染2例，腹腔感染1例；分期单项手术15例，颅内感染2例。结论：同期颅骨修补合并脑室—腹腔分流术较分期单项手术术后更容易发生感染，应分期手术。 【关键词】 脑积水； 颅骨缺损； 颅骨修补术； 脑室—腹腔分流术； 感染 Analysis of Infection Related Factors between the Early Cranioplasty and Ventricle—peritoneal Shunt with Staging the Single Postoperative/ZHOU Zhi—guo，ZHU Qing—feng，CHEN Jing.// Medical Innovation of China，2012，9（29）：051—052 【Abstract】 Objective：To explore the infection rates difference between the same period in cranioplasty ventriculo—peritoneal shunt and installments single surgical intracranial，to analyze the cause of infection—related factors and prevent strategies.Method：16 cases of hydrocephalus with skull defects in patients with intraventricular—peritoneal shunt cranioplasty surgery，and 15 cases of phased skull patch and shunt surgery postoperative infection data were analyzed retrospectively.Result：Over the same period surgery，in the 16 cases，seven cases were infected，within six months after surgery，four cases in which intracranial infection（1 death），wound infection in 2 cases，abdominal infection in 1 case，installments single surgery 15 cases，2 cases of intracranial infection.Conclusion：The infection of the same period intraventricular—peritoneal shunt cranioplasty were more than installments single surgical，so the operationg should be done in phases. 【Key words】 Hydrocephalus； Skull defect； Cranioplasty； Ventriculo—peritoneal shunt； Infection First—authors address：The 264 Hospital of PLA，Taiyuan 030001，China doi：10.3969/j.issn.1674—4985.2012.29.033 严重高血压性脑出血及重型颅脑损伤患者手术治疗是缓解颅内压增高及降低致死率的重要方法，颅骨缺损与脑积水是颅脑术后常见的并发症。术后3～6年是脑积水及颅骨缺损修补的重要时机。文献报道，手术方式分期手术和同期手术两种[1]。即先行脑室—腹腔分流术（ventriculo—peritoneal shunt，VPS），待3～6个月后再行颅骨修补术或者Ⅰ期脑室—腹腔分流联合颅骨缺损修补术。同期手术具有经济、效果好、并发症少的优点[2]，但是通过本科对16例同期颅骨修补并脑室—腹腔分流术的病例资料的回顾性分析提示，同期手术感染率明显高于分期单项手术。现将结果分析如下。 1 资料与方法