摘要
目的研究复发脑胶质瘤患者再次手术治疗,术后发生颅内感染的影响因素及病原学特点。方法回顾性收集手术治疗的复发脑胶质瘤82例,探讨术后颅内感染情况及影响因素,进行分析。同时收集同期行手术治疗的原发脑胶质瘤病例200例进行统计分析。采用χ~2检验进行单因素比较分析,二分类Logistic回归分析用于探讨复发性胶质瘤再次手术发生颅内感染的独立危险因素。结果复发脑胶质瘤组和原发脑胶质瘤组患者中分别有36例(43.90%)和12例(6.00%)发生颅内感染,且差异有统计学意义(P<0.05)。原发胶质瘤患者中年龄≥55岁、合并糖尿病、其他恶性肿瘤史、III-IV级病理分级、术前合并放化疗、术中脑室系统打开患者所占的比例显著低于复发胶质瘤患者(P<0.05)。年龄、术前合并糖尿病、术中打开脑室系统、手术时间≥4小时与复发性胶质瘤患者术后发生较高的颅内感染率有关(P<0.05)。36例复发胶质瘤颅内感染患者的脑脊液标本中共分离出25株病原菌,其中革兰氏阳性菌居多,占56.00%。多因素分析结果显示:相对于年龄<55岁者,年龄≥55岁的复发胶质瘤患者术后发生颅内感染风险的OR值为14.783(95%CI=1.011~216.058)。结论复发胶质瘤患者术后发生颅内感染的概率远大于原发胶质瘤患者。年龄、术前合并糖尿病、术中打开脑室系统、手术时间>4小时与复发性胶质瘤患者术后颅内感染率较高有关。年龄是复发胶质瘤患者术后发生颅内感染的独立危险因素。
Objective To explore the influencing factors and etiological characteristics of intracranial infection in patients with recurrent glioma after reoperation.Methods A total of 82 cases of recurrent glioma who had received surgery were retrospectively collected to investigate the postoperative intracranial infection and its influencing factors.Further analysis were conducted to explore the cerebrospinal fluid etiological characteristics of postoperative intracranial infection in patients with recurrent glioma.A total of 200cases of primary glioma treated with surgery at the same time were collected for comparative analysis.Univariate analysis using chi-square test and binary Logistic regression analysis were applied to investigate the independent risk factors for intracranial infection caused by recurrent glioma reoperation.Results There were 36(43.90%)and 12(6.00%)patients had intracranial infection in the recurrent glioma group and the primary glioma group respectively,and the difference was statistically significant(P<0.05).The proportion of patients with age≥55years,diabetes mellitus,history of other malignancies,III to IV pathological grading,history of radiochemotherapy and intraoperative ventricular system opening in patients with primary glioma was significantly lower than that of patients with recurrent glioma(P<0.05).Age,diabetes mellitus,intraoperative ventricular system opening,and operative time≥4hours were associated with higher postoperative intracranial infection rate in patients with recurrent glioma(P<0.05).A total of 25strains of pathogenic bacteria were isolated from cerebrospinal fluid specimens of 36patients with recurrent glioma intracranial infection,among which gram-positive bacteria were the majority(56.00%).The results of multivariate analysis showed that the OR value of postoperative risk of intracranial infection in patients with recurrent glioma aged≥55years was 14.783(95%CI=1.011~216.058).Conclusion The risk of postoperative intracranial infection was significantly higher in patients with recurrent glioma than in patients with primary glioma.Age,preoperative diabetes mellitus,intraoperative ventricular system opening,and operative time>4hours were associated with higher postoperative intracranial infection rate in patients with recurrent glioma.Age is an independent risk factor for postoperative intracranial infection in patients with recurrent glioma.
作者
李祥冬
牛朝诗
陈鹏
梅加明
姜晓峰
汪业汉
Li Xiangdong;Niu Chaoshi;Chen Peng(Department of Neurosurgery,Anhui ProvincialHospital Affiliated to Anhui Medical University,Hefei,230001,China)
出处
《立体定向和功能性神经外科杂志》
2020年第1期19-24,共6页
Chinese Journal of Stereotactic and Functional Neurosurgery
基金
中央引导地方科技创新专项项目(编号:2017070802D144,2019b07030001)
脑功能与脑疾病安徽省重点实验室绩效考核补助项目(编号:1606c08235)
关键词
复发脑胶质瘤
颅内感染
危险因素
病原学
Intracranial infection
Recurrent glioma
Independent risk factors
Etiology
作者简介
通讯作者:牛朝诗niuchaoshi@163.com
