内镜下经蝶入路切除垂体腺瘤术后颅内感染的危险因素分析

Risk factors relate to intracranial infection after endoscope-assisted surgery through endonasal transsphenoidal approach for pituitary adenomas

目的探讨内镜下经蝶入路切除垂体腺瘤术后发生颅内感染的危险因素。方法回顾性分析2012年1月至2016年1月内镜下经蝶入路手术治疗的123例垂体腺瘤的临床资料,采用多因素Logistic回归分析检验术后发生颅内感染的危险因素。结果 123例中,术后发生颅内感染11例(8.94%)。多因素Logistic回归分析结果显示,糖尿病、手术时间≥4 h、有脑脊液漏、术前使用激素是内镜下经蝶入路切除垂体腺瘤术后发生颅内感染的危险因素(P<0.05)。结论内镜下经蝶入路切除垂体腺瘤术后发生颅内感染的危险因素众多,临床应根据这些危险因素采取预防性处理,以减少颅内感染的发生率。

Objective To investigate the risk factors related to the intracranial infection after endoscope-assisted surgery through endonasal transsphenoidal approach for pituitary adenomas. Methods The clinical data of 123 patients with pituitary adenomas, who were treated by endoscope-assisted surgery through endonasal transsphenoidal approach from January, 2012 to January, 2016 were analyzed retrospectively. The risk factors related to the postoperative intracranial infection were analyzed by multivariate Logistic regression analysis. Results The rate of intracranial infection occurrence was 8.94% （11/123）. The multivariate Logistic regression analysis showed that the risk factors related to the intracranial infection after endonasal transspheaoidal surgery included diabetes, surgery time ≥4 h, cerebrospinal fluid leakage and preoperative use of hormone （P〈0.05）. Conclusion The intracranial infection after the endoscopic endonasal transsphenoidal surgery is related to many factors including diabetes, surgery time ≥4 h, cerebrospinal fluid leakage, preoperative use of hormone. The susceptible patients with above-mentioned risk factors should be given more attention and preventive treatment in order to reduce the incidence of intracranial infection.