Risk Factors Related To Intracranial Infection After The Surgery Of Cerebellopontine Angle Region

Objective:To explore the risk factors related to the intracranial infection after the surgery of cerebellopontine angle region in our department in order to provide the basis for its prevention and treatment.Methods:A retrospective analysis of 500 patients who underwent retromastoid craniotomy of CPA region in our department from March 2013 to March 2017.442 patients were selected and eventually included in the study.Record patient information in detail,including gender,age,length of stay,date of operation,duration of operation,preoperative diabetes mellitus,operator,type of disease(Pathology),whether there are implantable devices,whether use antibiotics prophylactically,whether there is subcutaneous effusion under the incision after operation,whether infection occurs after operation,whether lumbar puncture is performed or lumbar cistern drainage and so on.Thepossible risk factors of infection were analyzed by single factor an--alysis,and then multivariate logistic regression analysis was used to analyze the significantly different results.Correlation analysis and regression analysis were used to analyze the relationship between lu--mbar puncture or lumbar cistern drainage and hospital stay in patients with intracranial infection after operation and the effect of routine lumbar puncture on hospital stay.Results:Of the 442 patients enrolled,213 had postoperative intracranial infection,and the infection rate was 48.2%.Single factor analysis showed that: There were significant differences in the correlation between postoperative infection and preoperative diabetes mellitus,operative time,type of disease,operator,the presence of subcutaneous effusion(P<0.05).However,there were no significant differences in gender,age,operation season,the availability of implantable equipment and whether or not to use antibiotics before operation(P>0.05).The single factor analysis with statistical significance was included in the multivariate analysis,the binary logistic was used to analyze,and the forward stepwise method was used to screen the variables.The results excluded the operator.The variables included in the model were diabetes,and if the operation time was greater than 4 hours as well as disease categories.The days of hospitalization of patients with lumbar puncture were shorter than those without lumbar puncture,and the hospitalization time of patients with lumbar cistern drainage was shorter than that of patients without lumbar cistern.Postoperative routine lumbar puncture can reduce the length of hospital stay.Conclusions:1.The risk factors of intracranial infection after craniotomy in CPA area can be single factor or multiple factors combined with each other.In this study,it was found that diabetes mellitus,operative time > 4 h,disease type and subcutaneous effusion were independent risk factors for intracranial infection after craniotomy for CPA lesions.The postoperative intracranial infection is more likely to occur in space occupying lesions than in functional lesions.2.CPA lesions postoperative intracranial infection after lumbar puncture or drainage of the lumbar cistern is indeed helpful to control intracranial infection and can shorten the treatment time of intracranial infection.Routine lumbar puncture after CPA is beneficial to the recovery of patients and can reduce the length of stay.