经鼻蝶入路鞍区手术后并发蝶窦炎的临床分析

Clinical analysis of sphenoid sinusitis after transsphenoidal sellar surgery

目的分析经鼻蝶入路鞍区手术术后并发蝶窦炎的可能影响因素。方法回顾性分析2009年1月至2014年1月在天津市环湖医院经鼻蝶入路行鞍区手术的177例患者的临床资料，对每例患者均进行鼻内镜随访，对可能影响术后并发蝶窦炎的危险因素，如性别、年龄、疾病种类、手术方式、肿瘤大小、使用人工材料还是自体材料修补、术中是否使用EC耳脑胶等因素进行分析。采用SPSS17．0软件对数据进行统计学分析。结果177例经鼻蝶入路鞍区手术患者中34例（19．2％）术后发生了蝶窦炎。术中使用EC耳脑胶是术后发生蝶窦炎的唯一危险因素（分别为34．57％、6．25％，x2=22．701，P〈0．01）；而性别、年龄、疾病种类、手术方式、肿瘤大小、使用人工材料还是自体材料修补等因素对手术后并发蝶窦炎无影响（P值均〉0．05）。结论对经鼻蝶入路鞍区手术患者术后进行鼻内镜随访发现，手术中使用EC耳脑胶是术后发生蝶窦炎的危险因素。

Objective To analyze the possible influence factors of sphenoid sinusitis after endoscopic transsphenoidal sellar surgery. Methods A retrospective analysis of 177 patients who underwent transsphenoidal sellar surgery, from January 2009 to January 2014 in Tianjin Huanhu Hospital was performed. All patients were followed up with nasal endoscope. The risk factors of sphenoid sinusitis after surgery were analyzed statistically, such as sex, age, categories of disease, surgical produres, tumor size, using artificial or self material repair, with or without EC glue intraoperatively, etc. SPSS 17. 0 software was used to analyze the data. Results After surgery, there were 34 （ 19.2% ） patients developed postoperative sinusitis. EC glue was the sole risk factor for postoperative sinusitis（34. 57% vs 6. 25% ,X2 =22. 701 ,P 〈 0. 01 ）,but the sex, age, categories of disease, surgical produres, tumor size and patching material had no significant difference （ all P 〉 0. 05 ）. Conclusions In patients with endoscopic transsphenoidal sellar surgery, regular postoperative nasal endoscopic follow-up found that the use of EC glue was the risk factor for the development of postoperative sphenoid sinusitis.