高血压性基底节区出血引流术后颅内感染的危险因素

目的 探讨高血压性基底节区出血引流术后发生颅内感染的危险因素。方法 回顾性分析2015年5月~2020年4月引流术治疗的481例高血压性基底节区出血的临床资料。结果 481例中，术后发生颅内感染28例，发生率为5.8%；治愈24例，治愈率85.7%。28例颅内感染中，培养出致病菌26例，其中革兰阳性菌16例（61.5%），革兰阴性菌10例。多因素logistic回归分析显示年龄≥60岁、白蛋白水平<35 g/L、术前GCS评分≤8分、置管时间>3 d、鞘内注射>6次、引流管口漏是术后颅内感染的独立危险因素（P<0.05）。结论 高血压性脑出血引流术后颅内感染是受多种原因影响的，预防为主，防治结合，以降低术后颅内感染发生率及病死率。

Risk factors for intracranial infection of patients with hypertensive basal ganglia hemorrhage after minimally invasive puncture drainage

Objective To analyze the risk factors for intracranial infection of the patients with hypertensive basal ganglia hemorrhage (HBGB) after minimally invasive puncture drainage (MIPD). Methods The clinical data of 481 patients with HBGH who received MIPD from May 2015 to May 2020 were analyzed retrospectively. Results Of these 481 patients, 28 patients suffered from intracranial infection after operation, and the incidence rate was 5.8%. Twenty-four patients were cured, and the cure rate was 85.7%. Pathogenic bacteria were positively cultured in 26 of 28 patients with intracranial infection, including Gram-positive bacteria in 16 patients (61.5%) and Gram-negative bacteria in 10 patients. Multivariate logistic regression analysis showed that age ≥60 years, albumin level <35 g/L, preoperative GCS score ≤8 points, catheter placement time >3 days, intrathecal injection >6 times, and drainage tube orifice leakage were independent risk factors for intracranial infection (P<0.05). Conclusions Intracranial infection is a severe complication of the patients with HBGB after MIPD. Main factos are related to the intracranial infection. The method of prevention first and combination of prevention and treatment is recommended to reduce the incidence and mortality of postoperative intracranial infection.