内镜下经鼻蝶窦入路垂体瘤切除术颅内感染因素分析

Analysis of factors of intracranial infection after endoscopic resection of pituitary tumors through nasal sphenoid

目的分析经鼻蝶窦入路内镜下垂体瘤切除术的颅内感染因素。方法对163例垂体瘤切除术进行回顾性分析,并对可能感染因素进行多因素logistic逐步回归分析。结果 163例患者,术后感染16例,感染率9.82%;手术时间>7 h、有脑脊液漏者、糖尿病者、应用激素者、术前应用抗菌药物者和术后应用抗菌药物>7 d者的感染率分别为13.64%、15.22%、15.00%、9.89%、10.59%、9.30%,手术时间越长、伴有脑脊液漏和糖尿病是内镜下经鼻孔蝶窦入路切除垂体瘤感染影响因素(P<0.05),而术前是否应用激素、术前应用抗菌药物和术后应用抗菌药物对此手术后并发感染影响不明显。结论经鼻蝶窦入路内镜下垂体瘤切除术后颅内感染受多种因素的影响,也有待大样本的调查分析。

OBJECTIVE To analyze the factors of intracranial infection after endoscopic resection of pituitary tumors through the nose sphenoid.METHODS Retrospective analysis of 163 patients who had resection of pituitary tumor was performed,logistic regression analysis of the factors was carried out.RESULTS The total number of cases of postoperative infections were in 16 cases,the infection rate was 9.82%.Operation time more than 7 hours,there were cerebrospinal fluid leakage,diabetes,corticosteroids were the preoperative use of antibiotics and the use of antibiotics more than 7 days after the infection rates were 13.64%,15.22%,9.89%,10.59%,9.30% and 10.47%,respectively.The longer operative time,diabetes were associated with cerebrospinal fluid leakage and nostril transsphenoidal endoscopic pituitary tumor infection factors（P0.05）,and preoperative corticosteroids,preoperative use of antibiotics and postoperative antibiotics after the surgery complicated by infection had no obvious effect（P0.05）.CONCLUSION Intracranial infection after resection of pituitary adenomas is affected by many factors.