内镜下经鼻蝶垂体瘤切除术后颅内感染因素分析
发布时间：2019-03-07 19:41
【摘要】：目的：探讨内镜下经鼻蝶入路切除垂体瘤术后颅内感染相关危险因素.方法：对我院自2013年2月-2014年6月200例行内镜下经鼻蝶入路切除术患者资料进行回顾性分析,对术后可能引起颅内感染因素进行多因素Logistic回归分析.结果：200例患者中术后感染10例发生率为5%,其中脑脊液鼻漏24例,功能型垂体腺瘤8例,糖尿病患者4例,垂体功能低下2例,术后Logistic回归分析：脑脊液漏、糖尿病、手术时间超过4小时、术前未预防性使用抗生素、术后转ICU、术前应用糖皮质激素,是内镜下经鼻孔蝶窦入路切除垂体瘤术后颅内感染的主要影响因素有统计学意义差异P0.05,而患者术前垂体功能低下、肿瘤体积大小、术后使用激素、均不是影响术后颅内感染的主要因素。结论：内镜下经鼻蝶窦入路垂体瘤切除术后颅内感染因素重要为：脑脊液鼻漏、糖尿病患者、术前未预防性使用抗生素、手术时间超过4小时、术后转ICU患者.颅内感染应重点预防,术后严密观察患者体温变化并注意有无隐性脑脊液鼻漏,如有颅内感染迹象及早给予敏感抗生素治疗。
[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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1
本文编号：2436399
[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.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R651.1
【参考文献】
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1 汪波;陈要武;向丽红;贺兴友;;成人颅内感染住院病例分析[J];重庆医学;2011年20期
，本文编号：2436399
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