内镜下脑脊液鼻漏修补术后颅内感染的影响因素

发布时间：2018-02-03 09:05

本文关键词： 鼻内镜脑脊液鼻漏修补术颅内感染　出处：《中国内镜杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探究经鼻内镜下脑脊液鼻漏修补术后发生颅内感染的危险因素,以期能为后期治疗提供参考。方法选取2010年1月-2015年1月该院收治的80例经鼻内镜下脑脊液鼻漏修补术患者为研究对象,回顾性分析80例患者的临床资料,分析患者的年龄、性别、病因、漏口大小、漏口位置、既往有无颅内感染、预防性抗生素、术后应用抗菌药物7 d、手术次数、手术是否使用人工材料、修复材料的选择、脑脊液鼻漏修补失败与经鼻内镜下脑脊液鼻漏修补术后发生颅内感染的相关性。结果 80例患者中4例(5.00%)患者术后发生颅内感染,对4例患者进行脑脊液细菌培养,共分离出8株病原菌,包括3例革兰阴性菌和5株革兰阳性菌,革兰阳性菌主要为金黄色葡萄球菌,占40.00%。单因素分析结果显示,脑脊液鼻漏修补失败、手术操作不当、修复材料的选择、既往有颅内感染病史和漏口大小直径1 cm与经鼻内镜下脑脊液鼻漏修补术后发生颅内感染有一定的相关性(P0.05)。多因素Logistic分析结果显示,脑脊液鼻漏修补失败、手术操作不当、既往有颅内感染病史、修复材料的选择和漏口大小直径1 cm为经鼻内镜下脑脊液鼻漏修补术后发生颅内感染的独立危险因素(P0.05)。结论颅底漏口大小直径1 cm、有既往颅内感染史、脑脊液鼻漏修补失败和手术失败因素等多种因素均可能会增大经鼻内镜下脑脊液鼻漏修补术患者术后颅内感染的发生率。
[Abstract]:Objective to investigate the risk factors of intracranial infection after cerebrospinal fluid rhinorrhea repair under nasal endoscope. Methods from January 2010 to January 2015, 80 patients with cerebrospinal fluid rhinorrhea repaired by nasal endoscope were selected as the research objects. The clinical data of 80 patients were analyzed retrospectively. Age, sex, etiology, size of leak, location of leak, history of intracranial infection, prophylactic antibiotics were analyzed. The patients were treated with antibiotics for 7 days after operation. The number of operations, whether to use artificial materials, the choice of repair materials. The relationship between the failure of cerebrospinal fluid rhinorhinorrhaphy and intracranial infection after cerebrospinal rhinorhinorrhaphy was analyzed. Results Intracranial infection occurred in 4 out of 80 patients. Eight strains of pathogenic bacteria were isolated from cerebrospinal fluid of 4 patients, including 3 Gram-negative bacteria and 5 Gram-positive bacteria. The main Gram-positive bacteria were Staphylococcus aureus. The results of single factor analysis showed that cerebrospinal fluid rhinorrhea repair failed, the operation was improper, and the choice of repair materials. The history of intracranial infection and 1 cm diameter of leakage were correlated with intracranial infection after cerebrospinal fluid rhinorrhea repair (P0.05). Multivariate Logistic analysis showed that. The cerebrospinal fluid rhinorrhea repair failed, the operation was improper, and had a history of intracranial infection. The selection of repair materials and the diameter of the leak 1 cm were the independent risk factors for intracranial infection after cerebrospinal fluid rhinorhinorrhaphy under nasal endoscope. Conclusion the diameter of the skull base leak is 1 cm. Many factors, such as previous history of intracranial infection, failure of cerebrospinal fluid rhinorrhea repair and failure of surgery, may increase the incidence of intracranial infection in patients with cerebrospinal fluid rhinorhinoplasty under nasal endoscope.
【作者单位】：浙江省丽水市中心医院耳鼻咽喉科;
【分类号】：R765.9
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