| 摘要: |
| 目的 研究、分析脑外伤伴发颅内感染预后不良的相关因素。方法 选择2008 年1月至2012 年12 月经脑脊液培养证实颅内感染的脑外伤患者82 例，分析与出院时格拉斯哥昏迷评分（glasgow coma scale，GCS 评分）高低、单/ 多菌种感染以及G-/+菌感染的相关因素。结果 检出细菌97 株，最主要的致病菌是鲍曼不动杆菌，占所有病原菌的28.9%。入院时GCS 评分（OR= 7.44，95%CI 2.80~19.76，P＜0.01）、脑室外引流术（OR=9.594,95%CI 3.338~12.575，P＜0.01）、G-菌感染（OR=3.745,95%CI1.008~12.560，P＜0.05）以及肺炎（OR=3.225，95%CI 1.128~9.219，P＜0.05）与出院时GCS 评分高低相关；院内病死率在G-菌和G+菌感染组间存在统计学差异（OR=10.95，95%CI 0.6234~192.2，P＜0.05）。结论 入院时GCS 评分低、脑室外引流术、G-菌感染和肺炎与出院时GCS 评分高低相关，其中G-菌感染是发生院内死亡的高危因素。 |
| 关键词: 脑外伤 颅内感染 危险因素 |
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| Risk factors of prognosis in patients with intracranial infection secondary to brain injury |
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ZENG Shangfei, LOU Xiaohui, YANG Xiaoqing
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the Third Affiliated Hospital,Wenzhou Medical University
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| Abstract: |
| Objective To analyze the risk factors for short-term prognosis in brain injury patients complicated by intracranial infection. Methods The clinical data of 82 brain injury patients with intracranial infection confirmed by cerebrospinal fluid (CSF) culture in Huashan Hospital Trauma Center during January 2008 and December 2012 were retrospectively reviewed. Influencing factors related to Glasgow Coma Scale (GCS) at discharge, multiple microbial infection and G-/+ infection were analyzed. Results Total 97 bacterial strains from 82 patients were identified by CSF culture, and A. baumannii was the most common pathogenic bacteria (28.9%). GCS at admission (OR=7.44, 95%CI 2.80~19.76, P＜0.001), extra-ventricular drainage (EVD) (OR=9.594, 95%CI 3.338~12.575, P=0.001), G- infection (OR=3.745, 95%CI 1.008~12.560, P=0.034) and pneumonia (OR=3.225, 95%CI 1.128~9.219, P=0.029) were the main risk factors for poor GCS at discharge. There was significant difference in hospital fatality(OR=10.95, 95%CI 0.6234~192.2, P=0.0327) between patients with G- and G+ bacterial infection. Conclusion GCS at admission, EVD, G- infection and pneumonia are risk factors associated with the poor GCS at discharge and G- bacterial infection is related to higher in-hospital mortality. |
| Key words: Traumatic brain injury Intracranial infection Risk factor |
