摘要
目的分析内镜辅助下经鼻蝶入路垂体瘤切除术颅内感染的危险因素以及防治措施。方法回顾性分析2010年11月至2017年10月期间我院神经外科采取内镜辅助下经鼻蝶入路垂体瘤切除术的529例患者的详细临床资料,单因素和Logistic多因素回归分析影响颅内感染的危险因素。结果 33例(6.24%)垂体瘤患者发生术后颅内感染。经卡方检验,颅内感染的发生率与肿瘤体积、术前合并糖尿病以及激素和抗生素使用情况、术中脑脊液漏、鞍隔破损、术中出血量和手术时间、术后使用激素情况和护理方式有明显的相关性(P<0.05)。经Logistic多因素回归分析,术后留置引流管、术中脑脊液漏、鞍隔破损、术后使用激素是颅内感染的独立危险因素,Exp(B)=17.827,14.175,6.354,9.463,P<0.05。结论术后留置引流管、术中脑脊液漏、鞍隔破损、术后使用激素会增加颅内感染的发生率,属于独立危险因素,需采取针对性有效的预防处理措施。
Objective To analyze the risk factors and the related therapeutic strategies of postoperative intracranial infection of patients with pituitary adenoma resection by transnasal transsphenoidal approach.Methods 529 patients with pituitary adenoma resection by transnasal transsphenoidal approach from November 2010 to October 2017 in our hospital were retrospectively analyzed.The risk factors of postoperative intracranial infection were analyzed by χ-2 test and Logistic regression multivariate analysis.Results There were 33 patients（6.24%）with intracranial infection after pituitary adenoma resection by transnasal transsphenoidal approach.The postoperative intracranial infection were related with the tumor size,diabetes,corticosteroids and antibiotics before suegery,cerebrospinal fluid leakage,defect of the sella diaphragm,the bleeding volume in operation and the operation time,the drainage pipe,corticosteroids after surgery and nursing care（P〈0.05）by univariate analysis.The postoperative drainage pipe,cerebrospinal fluid leakage,defect of the sella diaphragm and corticosteroids after surgery were the risk factors tested by Logistic regression multivariate analysis（P〈0.05）.Conclusion The postoperative drainage pipe,cerebrospinal fluid leakage,defect of the sella diaphragm and corticosteroids after surgery were the risk factors of postoperative intracranial infection,which would be given more attention and prophylaction treatment.
作者
刘宏志
尹丽萍
冯进
Liu Hongzhi;Yin Li-ping;Feng Jin(Department of Neurosurgery,Xingtai First Hospital,054000,China)
出处
《立体定向和功能性神经外科杂志》
2018年第3期141-145,共5页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
垂体瘤
内镜
经鼻蝶入路垂体瘤切除术
颅内感染
危险因素
Pituitary adenoma
Transnasal transsphenoidal approach
Pituitary adenoma resection
Intracranial infection
Risk factor
