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基于26年的单一中心经验,关于预防和管理深度脑刺激感染的建议

Johannes Kähkölä^1,2, Teija Puhto^2,3, Jani Katisko^1,2,4

¹Oulu Research Group of Advanced Surgical Technologies and Physics - ORGASTP, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland.

Stereotactic and functional neurosurgery

|June 27, 2024

概括

深度大脑刺激 (DBS) 感染是严重但罕见的. 这项研究建议积极的手术修复和特定的抗生素治疗DBS感染,强调预防策略.

科学领域:

神经外科神经外科
传染性疾病传染性疾病
医疗器械技术医疗器械技术

背景情况:

深度大脑刺激 (DBS) 感染可能导致治疗停止和患者发病率增加.
缺乏关于有效的感染预防策略的科学共识,需要进一步的研究.
这项研究报告了26年的DBS感染的单一中心经验,以告知预防和管理.

研究的目的:

分析深度大脑刺激 (DBS) 感染率和26年来在一个中心的结果.
为预防和管理与DBS相关的手术部位感染 (SSI) 提供基于证据的建议.
评估实施的感染预防措施对SSI率的影响.

主要方法:

追溯分析了1997年至2022年期间进行的978次深度脑刺激 (DBS) 手术.
包括DBS电极和可植入脉冲发生器 (IPG) 的初级/再植入手术.
手术部位感染 (SSI) 的定义是手术后一年内没有二次原因的感染;2013年之前和之后的感染率的统计比较.

主要成果:

总共有35个DBS植入物被感染,中心特异性手术部位感染 (SSI) 率为3.1%.
金黄色葡萄球菌是主要的病原体 (75.0%),其中32.1%是混合感染.
在实施预防措施后,没有观察到SSI率的统计学上显著差异 (p=0.051).

结论:

现代深度大脑刺激 (DBS) 程序表现出低的手术感染率,但其严重后果需要强有力的预防措施.
对DBS感染的抗生素选择必须考虑混合感染的高患病率.
对DBS手术部位感染 (SSI) 的推治疗包括积极的手术修复加上适当的抗生素治疗.

关键词:

抗生素抗生素是一种抗生素.复杂性复杂性复杂性深度大脑刺激是什么?感染感染感染预防预防预防

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