目的 总结近十年来颅脑手术后颅内感染的发病率、病死率及病原菌谱，为制订预防颅内感染措施提供依据。 方法 检索中国学术期刊网全文数据库（CNKI）、万方数据库、重庆维普中文科技期刊全文数据库，并辅以文献追溯、手工检索等方法收集2001年－2012年国内正式刊物上公开发表的有关颅脑手术后颅内感染的中文文献。并对颅脑手术后颅内感染的流行病学调查资料进行Meta分析。 结果 共有27篇论文进入Meta分析，其中，25篇论文用于颅脑手术后颅内感染发病率的统计。共调查40 343例，发生颅内感染1 712例，感染率为4.24%。6篇论文提供了开颅术后颅内感染死亡的数据，在268例颅内感染患者中死亡39例，病死率为14.55%。15篇论文统计显示，颅内感染细菌培养阳性率为54.48%；15篇论文给出细菌培养结果，其中金黄色葡萄球菌占23.16%，表皮葡萄球菌占17.85%，铜绿假单胞菌占8.85%，大肠埃希菌占8.70%。 结论 国内颅脑手术后颅内感染以G+球菌为主，病原菌分布相对集中，临床上应予以重视。
Objective To investigate the accuracy of preoperative three-dimensional reconstruction of tumor in craniotomy for supratentorial convex brain tumors, and to provide an accurate and safe auxiliary method for craniotomy. Methods Patients with supratentorial convexity brain tumors who were admitted to the Department of Neurosurgery, West China Hospital, Yibin Hospital, Sichuan University between April 2018 and November 2020 were prospectively enrolled and randomly divided into reconstruction group and control group. In the reconstruction group, preoperative three-dimensional reconstruction of the tumor was used for craniotomy positioning, while in the control group, traditional two-dimensional tomographic imaging was used. The basic conditions, intraoperative localization and tumor exposure satisfaction rate, maximum diameter of bone window, operation time, cerebral draining vein injury, and postoperative subcutaneous effusion or intracranial infection were compared between the two groups. Results A total of 43 patients were included, 22 in the reconstruction group and 21 in the control group. There was no significant differences in age, gender composition, incidence of midline shift, tumor growth site and tumor size between the two groups (P>0.05). There was no significant difference in the incidence of cerebral drainage vein injury and postoperative subcutaneous effusion or intracranial infection between the two groups (P>0.05). The satisfaction rate of intraoperative positioning and tumor exposure in the reconstruction group (95.5% vs. 66.7%) was higher than that in the control group, the maximum diameter of the bone window [(6.26±1.32) vs. (7.31±1.13) cm] and the operation time [(194.00±22.76) vs. (214.57±26.53) min] were lower than the control group, and the differences were statistically significant (P<0.05). Conclusions Preoperative three-dimensional reconstruction helps to locate the tumor more accurately, improves the satisfaction rate of tumor exposure, reduces the diameter of the craniotomy window, and shortens the operation time. Compared with traditional two-dimensional tomographic positioning, it has more advantages.