神经外科颅脑手术患者发生术后颅内感染的危险因素及应用中医外科"托法"效果分析

摘要 目的：探讨神经外科颅脑手术患者术后发生颅内感染的危险因素,并研究中医外科"托法"辅助治疗颅内感染的临床疗效。方法：回顾性分析2017年1月到2022年12月在我院神经外科进行颅脑手术的260例患者临床资料,分析影响患者发生术后颅内感染的影响因素。发生术后发生颅内感染的患者在常规抗感染治疗的基础上加用中医"托法"治疗,分析其临床治疗疗效、抗感染治疗后脑脊液白细胞计数、蛋白含量和中性粒细胞,以及血清白介素-8（IL-8）,超敏c反应蛋白（hs-CRP）和降钙素（PCT）。结果：260例神经外科颅脑手术患者,术后出现颅内感染的患者有21例,术后颅内感染发生率为8.08%。多因素Logistic回归分析显示：手术时间、脑脊液分流术、脑室外引流以及脑脊液漏是影响神经外科颅脑手术患者术后是否发生颅内感染的独立影响因素。经中医外科"托法"辅助抗感染治疗后,21例术后颅内感染患者脑脊液白细胞计数、蛋白含量和中性粒细胞均较治疗前显著降低（P<0.05）,并且血清IL-8、hs-CRP和 PCT均较治疗前降低（P<0.05）。21例术后颅内感染患者治疗总有效率、抗感染治疗时间和总费用分别为90.48%、（11.43±1.57）天和（7571.68±2541.29）元。结论：手术时间、脑脊液分流术、脑室外引流以及脑脊液漏是影响神经外科颅脑手术患者术后是否发生颅内感染的独立影响因素,中医外科"托法"可用于术后颅内感染患者抗感染治疗。

Risk Factors of Postoperative Intracranial Infection in Neurosurgery Patients Undergoing Craniocerebral Surgery and the Analysis of the Effect of Applying "Support Therapy " in Traditional Chinese Medicine Surgery

ABSTRACT Objective: To explore the risk factors of intracranial infection in neurosurgery patients after craniocerebral surgery, and to study the clinical efficacy of traditional Chinese medicine surgery "Tufa" as an auxiliary treatment for intracranial infection. Methods: Retrospectively analyze the clinical data of 260 patients who underwent craniocerebral surgery in neurosurgery of our hospital from January 2017 to December 2022, and analyze the influencing factors of postoperative intracranial infection. Patients with postoperative intracranial infection were treated with traditional Chinese medicine "Tuofe" on the basis of conventional anti infection treatment, and their clinical therapeutic efficacy, cerebrospinal fluid leukocyte count, protein content and neutrophils, as well as serum interleukin-8 (IL-8), hypersensitive C-reactive protein (hs CRP) and Calcitonin (PCT) after anti infection treatment were analyzed. Results: Among 260 patients undergoing neurosurgery craniocerebral surgery, 21 patients had intracranial infection after surgery, and the incidence of postoperative intracranial infection was 8.08%. Multivariate logistic regression analysis showed that operation time, cerebrospinal fluid shunt, external ventricular drainage and cerebrospinal fluid leakage were independent factors influencing whether intracranial infection occurred after neurosurgery craniocerebral surgery. After using the traditional Chinese medicine surgical "support method" to assist in anti infection treatment, the cerebrospinal fluid white blood cell count, protein content, and neutrophils of 21 patients with postoperative intracranial infection were significantly reduced compared to before treatment(P<0.05), and serum IL-8, hs CRP, and PCT were all reduced compared to before treatment (P<0.05). The total effective rate, anti infection treatment time, and total cost of 21 postoperative intracranial infection patients were 90.48%(11.43±1.57) days, and (7571.68±2541.29) yuan, respectively. Conclusion: Operation time, cerebrospinal fluid shunt, external ventricular drainage and cerebrospinal fluid leakage are independent influencing factors that affect whether intracranial infection occurs after craniocerebral surgery in neurosurgery patients. Traditional Chinese medicine surgery "support therapy" helps to improve the anti infection treatment effect of patients with intracranial infection after surgery.