与静脉切除术相关的感染:通过终止脑脊髓液查,减少发病率
Antonio Fernandez1, Erik Uvelius1, Erik Kronvall1
1Department of Neurosurgery, Skåne University Hospital, Lund, Sweden.
World neurosurgery
|November 3, 2023
概括
在神经重症监护病房使用脑脊髓液 (CSF) 取样进行两周一次的室内静脉切除相关感染 (VRI) 查,但并没有降低感染率或改善患者的治疗结果. 这种做法甚至可能增加感染,不建议使用.
科学领域:
- 神经科学是一个神经科学.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 外腔室排水 (EVDs) 在神经重症监护室 (NICU) 中至关重要.
- 风口切口相关感染 (VRI) 是EVDs的频繁和严重并发症.
- 评估常规VRI查的影响对于患者管理至关重要.
研究的目的:
- 评估每两周抽取脑脊液 (CSF) 样本用于VRI查的效果.
- 确定查是否影响神经临床护理患者的临床过程和VRI率.
- 评估VRI查对NICU停留时间和分流依赖性的影响.
主要方法:
- 对EVD患者的回顾性分析.
- 对一个每两周一次接受脊髓样本采集的队列与仅根据临床指示采样的队列进行比较.
- VRI被定义为疑似或培养确认的病例;结果包括NICU停留时间和分流依赖.
主要成果:
- 整体VRI治疗率 (22%) 没有受到查的影响.
- 查与培养证实VRI的更高率有关 (OR,2.86).
- 埃博拉病毒病持续时间是主要的VRI风险因素;阳性培养与更长的NICU停留时间和增加的分流手术风险相关.
结论:
- 每两周进行一次VRI查并没有降低VRI发病率或改善临床结果.
- 查并没有使早期的VRI检测成为可能,也没有降低脑水症的发病率.
- 频繁取 CSF 样本可能会导致 VRI;不建议进行常规查.
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