经鼻蝶窦入路垂体瘤切除术后并发颅内感染相关因素分析

Risk factors for postoperative intracranial infection in endonasal transsphenoidal surgery for pituitary adenoma

目的探讨经鼻蝶窦入路垂体瘤切除术后并发颅内感染的相关因素。方法回顾性分析2013年1月-2017年10月于医院进行内镜下经鼻蝶窦入路垂体瘤切除术的543例患者的临床资料和手术信息,归纳患者术后颅内感染的相关因素。结果 543例内镜下经鼻蝶窦入路垂体瘤切除患者中,23例术后发生颅内感染,感染率为4.24%;共培养分离病原菌18株,其中革兰阴性菌10株占55.56%,革兰阳性菌7株占38.89%,真菌1株占5.56%;肿瘤直径>1cm,手术时间和术后脑脊液漏是患者术后并发颅内感染的相关因素(P<0.05)。结论肿瘤直径较大,手术时间过长及术后脑脊液漏的患者术后发生颅内感染的风险较高,应采取有效防控措施来降低医院感染的发生。

OBJECTIVE To investigate and analyze the risk factors for postoperative intracranial infection in endonasal transsphenoidal surgery for pituitary adenoma.METHODS The clinical data and surgical information of 543 patients who received endonasal transsphenoidal surgery for pituitary adenoma in our hospital from Jan.2013 to Oct.2017 were retrospectively analyzed.The related factors of postoperative intracranial infection in patients.RESULTS Of the 543 patients who received endonasal transsphenoidal surgery for pituitary adenoma,23 patients had postoperative intracranial infections,with the infection rate of 4.23%.Totally 18 strains of pathogens were isolated from the patients,of which 10（55.5%）strains were gram-positive bacteria,7 strains（38.9%）were gram-negative bacteria,and 1 strain（5.6%）was fungus.The tumor diameter〉1 cm,operation time and leakage of cerebrospinal fluid were risk factors for postoperative intracranial infections（P〈0.05）.CONCLUSION Large tumor size,long operation time and leakage of cerebrospinal fluid were high risk factors of intracranial infections after endonasal transsphenoidal surgery for pituitary adenoma,and it is necessary to take targeted measures aiming at the influencing factors to reduce the postoperative infection.