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Prevention of postoperative intracranial infection in patients with cerebrospinal fluid rhinorrhea

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收录情况: ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 中华系列

机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing 100050, Peoples R China; [2]Capital Med Univ, Beijing Neurosurg Inst, Beijing 100050, Peoples R China
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关键词: cerebrospinal fluid rhinorrhea prevention postoperative intracranial infection

摘要:
Background Intracranial infection is a common postoperative complication of neurosurgery.This study aimed to identify risk factors of postoperative intracranial infection in patients with cerebrospinal fluid rhinorrhea and to suggest proposals for the prevention.Methods A total of 167 patients (113 males and 54 males,average age of 34.4 years) with cerebrospinal fluid rhinorrhea operated on by the senior author were retrospectively reviewed.The data collected included etiology,previous history,clinical manifestation,site of bone defect,operative approach,and postoperative complications.Risk factor(s) for postoperative infection were analyzed using the stepwise multiple Logistic regression.Results Eighteen (10.8%) patients were infected post-operatively.The independent risk factors for infection were the site of defect (RR=0.508,95% Cl 0.306-0.843,P=0.009) and historical meningitis (RR=0.290,95% Cl 0.094-0.893,P=0.031).Patients with multiple defects and saddle floor defects had a higher infection rate.The germiculture was positive in 11 patients,and vancomycin was sensitive to all the pathogenesis.Nine infected patients needed lumbar drainage.Ten patients had hyponatremia,and hydrocephalus occurred in two patients with serious trauma.Conclusions To prevent the infection,we should pay closer attention to the high-risk patients pre-operation.During the operation,the methods those can improve wound healing,such as using blood-supply materials,reliable fixation,and eliminating dead space are all helpful.Conducting lumbar drainage and choosing effective prophylactic antibiotics in the early postoperative stage for the high-risk patients are methods of postoperative management.

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出版当年[2010]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
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出版当年[2009]版:
Q3 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2009版] 出版当年五年平均 出版前一年[2008版] 出版后一年[2010版]

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