神经内镜手术后发热反应的临床观察及其意义

Febrile response after neuroendoscopic surgery:clinical observation and its significance

目的总结和分析神经内镜术后发热反应的特点。方法回顾性分析88例符合纳入标准的行神经内镜手术治疗病人的临床资料。将病人按手术方式分为5组:外侧裂蛛网膜囊肿造瘘组(SAC)、脑室内蛛网膜囊肿切除组(VAC)、透明膈造瘘组(SPF)、第三脑室底造瘘组(ETV)、脉络丛烧灼术组(CPC),分别总结各组病人的术后发热反应特点。结果术后发热反应以CPC组最重。术后达到最高体温的时间所有病人均不超过术后第3天。ETV组术后最高体温可出现在手术后当日的数小时内,而非ETV组病人无此现象。结论电凝烧灼、坏死组织残留、下丘脑刺激、脑脊液循环能力等多种因素,使神经内镜手术后可出现不同程度的发热反应。

Objective To summarize and analyze the characteristics of febrile response after neuroendoscopic surgery. Methods The clinical materials of 88 patients undergoing neuroendoscopic surgery and meeting the criteria were retrospectively analyzed. According to the type of surgery, the patients were divided into five groups： fenestration for sylvian amchnoid cysts （SAC） group, intraventricular arachnoid cyst resection （VAC） group, septum pellucidum fistulization （SPF） group, third ventriculostomy （ETV） group, and choroid plexus coagulation （CPC） group. The characteristics of postoperative febrile response in all the groups were summarized and analyzed. Results The postoperative febrile response in CPC group was the severest. The time to the highest body temperature did not exceed the third postoperative day in all the cases. In some of the patients undergoing ETV, the highest body temperature occurred a few hours postoperatively. Conclusion Multiple factors, including electrical coagulation, necrotic tissue remnant, hypothalamic stimulation, characteristics of cerebrospinal fluid circulation, contribute to postoperative febrile response ofneuroendoscopic surgery.