【摘要】：目的：探討內鏡下經(jīng)鼻蝶入路切除垂體瘤術后顱內感染相關危險因素.方法：對我院自2013年2月-2014年6月200例行內鏡下經(jīng)鼻蝶入路切除術患者資料進行回顧性分析,對術后可能引起顱內感染因素進行多因素Logistic回歸分析.結果：200例患者中術后感染10例發(fā)生率為5%,其中腦脊液鼻漏24例,功能型垂體腺瘤8例,糖尿病患者4例,垂體功能低下2例,術后Logistic回歸分析：腦脊液漏、糖尿病、手術時間超過4小時、術前未預防性使用抗生素、術后轉ICU、術前應用糖皮質激素,是內鏡下經(jīng)鼻孔蝶竇入路切除垂體瘤術后顱內感染的主要影響因素有統(tǒng)計學意義差異P0.05,而患者術前垂體功能低下、腫瘤體積大小、術后使用激素、均不是影響術后顱內感染的主要因素。結論：內鏡下經(jīng)鼻蝶竇入路垂體瘤切除術后顱內感染因素重要為：腦脊液鼻漏、糖尿病患者、術前未預防性使用抗生素、手術時間超過4小時、術后轉ICU患者.顱內感染應重點預防,術后嚴密觀察患者體溫變化并注意有無隱性腦脊液鼻漏,如有顱內感染跡象及早給予敏感抗生素治療。
[Abstract]:Objective: to investigate the risk factors of intracranial infection after endoscopic transsphenoidal resection of pituitary adenomas. Methods: the data of 200 patients undergoing endoscopic transsphenoidal resection from Feb.2013 to June 2014 in our hospital were retrospectively analyzed. The possible factors of intracranial infection after operation were analyzed by Logistic regression analysis. Results: the incidence of postoperative infection was 5% in 10 cases, including 24 cases of cerebrospinal fluid rhinorrhea, 8 cases of functional pituitary adenomas, 4 cases of diabetes mellitus and 2 cases of hypophysis dysfunction. Logistic regression analysis showed that cerebrospinal fluid leakage, diabetes mellitus, and hypophysis were found in 24 cases, 8 cases of functional pituitary adenoma, 4 cases of diabetes mellitus. The operation time was more than 4 hours, no prophylactic antibiotics were used before operation, and corticosteroids were used before ICU, after operation. The main influencing factors of intracranial infection after endoscopic transsphenoidal surgery for pituitary adenomas were P 0.05, but the patients had lower pituitary function before operation, tumor size, and postoperative use of hormone, and there was no significant difference between the two groups (P < 0.05). All of them were not the main factors affecting postoperative intracranial infection. Conclusion: the important factors of intracranial infection after endoscopic transsphenoidal pituitary adenoma resection are cerebrospinal fluid rhinorrhea, diabetes mellitus, no prophylactic use of antibiotics before operation, operation time more than 4 hours, and postoperative conversion to ICU. We should pay attention to the prevention of intracranial infection, observe the change of body temperature closely after operation and pay attention to whether there is recessive cerebrospinal fluid rhinorrhea or not. If there are signs of intracranial infection, sensitive antibiotics should be given as soon as possible.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R651.1

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