颅脑肿瘤患者术后发热原因分析

Analysis of causes of postoperative fever in brain tumors

目的探讨颅脑肿瘤患者术后发热的原因,为颅脑肿瘤患者术后发热的诊疗提供相关依据。方法选取行颅脑肿瘤手术的120例患者资料。所有颅脑肿瘤患者均符合中国临床肿瘤学会(CSCO)制定的《2018. V1版头颈部肿瘤诊疗指南》中的诊断标准,首次发病且入院前未行过开颅手术,无严重的肺、肝、肾功能不全,无颅外肿瘤、术前感染及自身免疫性疾病。以患者的腋窝温度大于37. 3℃为发热,将120例患者分为发热组和无发热组。分析发热组患者的血、尿、便、生化全项,心电图,胸片,头CT等实验室检查结果。比较发热组及无发热组患者的年龄、性别、手术时间、麻醉后复苏时间、手术并发症发生率的差异。结果本研究中发热组患者86例,占患者总数的71. 7%。其中中枢性高热38例(44. 2%),脱水热15例(17. 4%),吸收热14例(16. 2%),再出血热3例(0. 4%),颅内感染3例(3. 4%),肺部感染8例(9. 3%),其他部位感染5例(5. 8%)。发热组与非发热组患者的年龄、麻醉后复苏时间、手术时间及术后并发症发生率差异均有统计学意义(P <0. 05)。结论中枢性高热为颅脑肿瘤患者术后发热的主要原因,但感染等其他因素亦占有一定比例。尽量缩短手术时间、减少麻醉后复苏时间及避免术后并发症可以减少术后患者发热概率。

Objective To analyse the causes of fever in patients with craniocerebral tumor after operation.Methods The data of 120 patients who performed craniocerebral tumor surgery were randomly selected.All patients with craniocerebral tumors meet the diagnostic criteria in the Guidelines for the Diagnosis and Treatment of 2018.V1 Edition Neck Tumors Developed by the Chinese Society of Clinical Oncology (CSCO):first onset and no craniotomy prior to admission,no severe lung,liver,renal insufficiency,no extra-cranial tumors,preoperative infections and autoimmune diseases.Taking the patient's armpit temperature greater than 37.3 ℃ as fever,120 patients were divided into fever Group and no Fever group.The results of blood,urine,stool,biochemical test,electrocardiogram,chest and head CT of the patients in the heating group were analyzed,and the proportion of the causes of fever was discussed.The differences of age,sex,operationtime,recovery time after anesthesia and incidence of surgical complications were compared among patients with fever group and no Fever group.Results 86 patients in the fever group accounted for 71.7% of the total number of patients.Among them,38 cases of central hyperthermia (44.2%),15 cases of dehydration heat (17.4%),14 cases of absorption heat (16.2%),3 cases of hemorrhagic fever (0.4%),3 cases of intracranial infection (3.4%),8 cases of pulmonary infection (9.3%),and 5 cases of infection in other parts (5.8%).The comparison of age,postoperative resuscitation time,operation time and postoperative complication rate between the febrile group and the non-febrile group was statistically significant (P<0.05).Conclusions Central hyperthermia is the main cause of postoperative fever in patients with craniocerebral tumors,but other factors such as infection also accounts for a certain proportion.Minimizing the operation time,reducing the recovery time after anesthesia and avoiding postoperative complications can reduce the risk of fever for postoperative patients.