Abstract: Objective To explore the correlation between external cerebrospinal fluid(CSF) drainage and intracranial infection after craniotomy in children.Methods The clinical data of 253 children who received craniotomy in pediatric neurosurgical ward of Beijing Tiantan Hospital, Capital Medical University between December 2018 and September 2019 were analyzed retrospectively. Results Among the 253 children cases, 113 cases had CSF external drainage after operation, the average retention time was 9 days (2-23 days). The incidence of postoperative intracranial infection was 30% (76/253) in all the 253 children and 54% (61/113) in those with external CSF drainage. Univariate analysis (χ²=55.702, P<0.001) and multivariate analysis (OR=8.045, 95% CI: 4.121-15.703, P<0.001) showed that indwelling external drainage tube was an independent risk factor for intracranial infection. Among 113 cases, 41 cases were treated with open external drainage system of CSF after operation. Statistics showed that the rate of intracranial infection in the open group was higher than that in the closed group (75.6% vs 41.6%, χ²=12.116,P<0.001). The incidence of intracranial infection was directly proportional to the drainage time. On the fifth day, the infection rate and the accumulated infection rate were the lowest, 25% and 27%, respectively. The time for antibiotics use and postoperative hospital stay of the patients with intracranial infection who received CSF drainage within one week were shorter than those longer than one week (9.37 d vs 12.32 d, t=-2.441, P=0.018; 24.33 d vs 36.29 d, Z=-2.624, P=0.009). Conclusion Reasonable retention of external CSF drainage after craniotomy in children, keeping the drainage tube system closed and pulling out the drainage tube as early as possible may help to reduce the incidence of intracranial infection related to drainage.

Key words: children, craniotomy, cerebrospinal fluid drainage, intracranial infection