颞叶癫痫术后发热分析

Analysis of postoperative fever of temporal lobe epilepsy

目的探讨颞叶癫痫手术后发热的原因以及处理方法。方法 2014年6月至2016年12月我科收治的80例颞叶癫痫手术患者,随机分为分不引流组(D_1)40例、硬膜外引流组(D_2)20例、硬膜下和硬膜外同时引流组(D_3)20例,记录每组患者术中出血量、外周血常规白细胞计数、术后体温大于38.5℃患者数、腰椎穿刺患者数、疑似感染患者数等。结果 D_2,D_3两组患者术后发热、腰穿患者例数少于D_1组,术后外周血白细胞计数也较较D_1减少,差异有统计学意义(P<0.05);术中出血量较多,术后发热的患者数较多。结论颞叶癫痫患者,术后发热多为非感染性发热;术中出血较多者,需要安置硬膜外引流或者硬膜下、硬膜外同时引流,术腔引流能显著减少患者术后发热的程度,有利于减少术后并发症的发生,避免或减少腰穿次数,促进患者的快速康复。

Objective To evaluate the causes and treatment of fever after temporal lobe epilepsy surgery.Methods From June 2014 to December 2016,80 patients with temporal lobe epilepsy were randomly divided into three groups： non-drainage group（ D1）（ n= 40）,epidural drainage group（ D2）（ n = 20） and subdural and epidural drainage group（ D3）（ n = 20）.The intraoperative blood loss,peripheral blood routine white blood cell count,number of patients with postoperative body temperature higher than 38. 5（ C,number of patients with lumbar puncture,and number of suspected infected patients were recorded. Results The number of patients with fever and lumbar puncture in the group D2 and D3 was less than those in the group D1（ P〈0. 05）.The D2 and D3 groups also had lower peripheral white blood cell counts than the D1 group（ P〈0. 05）.Patients had more intraoperative blood loss,the more postoperative fever occurred.Conclusion In patients with temporal lobe epilepsy,the postoperative fever is mostly non-infectious fever. Patients with multiple bleeding need to place epidural drainage or subdural and epidural drainage.This can reduce the degree of postoperative fever and the incidence of postoperative complications,avoid or reduce the number of lumbar puncture,and promote the rapid recovery.