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目的脑肿瘤手术患者特别是输血后,并发术后感染的危险性显著增加,给临床治疗与术后恢复带来不利影响,因此本研究主要探讨脑膜瘤手术输血患者发生术后感染的相关危险因素,分析相互因果关系,揭示独立危险因素,为临床预防和控制术后感染提供依据。方法前瞻性观察2012年3月—2014年3月360例患者(男性患者192例,女性患者168例)的术后感染情况,以患者是否并发术后感染为因变量,同时以选择术后感染可能的相关危险因素为自变量,并对相关危险因素进行非条件logistic回归分析。结果单因素相关分析结果显示,年龄(OR=3.318,P=0.032)、手术时间(OR=3.281,P=0.028)、术中出血量(OR=5.133,P=0.001)、术中输血量(OR=4.518,P=0.003)、术前合并呼吸(OR=2.993,P=0.016)、肝(OR=2.905,P=0.046)、肾(OR=3.020,P=0.047)功能障碍等方面的差异具有统计学意义;而进一步的多因素logisitic回归分析发现,手术时间(OR=2.872,P=0.044)、术中出血量(OR=3.000,P=0.026)、输血量(OR=3.013,P=0.021)与术前合并呼吸疾病(OR=3.018,P=0.035)是术后感染的独立危险因素。结论手术时间、术中出血量、输血量与术前合并呼吸疾病等是脑膜瘤手术输血患者并发术后感染的独立危险因素,预防的关键在于做好术前评估与围术期输血管理。
Objective The risk of postoperative infection in patients with brain tumor surgery, especially after transfusion, is significantly increased, which brings adverse effects on clinical treatment and postoperative recovery. Therefore, this study mainly focused on the risk factors of postoperative infection in patients with meningiomas , Analyze mutual causation, reveal independent risk factors and provide evidence for clinical prevention and control of postoperative infection. Methods Prospective observation From March 2012 to March 2014, 360 patients (192 males and 168 females) were retrospectively analyzed. The postoperative infection was analyzed as the dependent variable. At the same time, the patients were selected for postoperative infection Possible related risk factors were independent variables, and non-conditional logistic regression analysis of related risk factors. Results The results of one-way ANOVA showed that the average number of blood transfusions (OR = 3.318, P = 0.032), operation time (OR = 3.281, P = 0.028), intraoperative blood loss OR = 4.518, P = 0.003), preoperative combined respiration (OR = 2.993, P = 0.016), liver (OR = 2.905, P = 0.046) (OR = 3.000, P = 0.026), blood transfusion volume (OR = 3.013, P = 0.026), blood loss 0.021) and preoperative combined respiratory disease (OR = 3.018, P = 0.035) were independent risk factors for postoperative infection. Conclusions The operation time, intraoperative blood loss, blood transfusion and preoperative combined respiratory disease are independent risk factors for postoperative infection in patients with meningioma after transfusion operation. The key to prevention is preoperative evaluation and perioperative blood transfusion management.