摘要
目的分析垂体腺瘤患者经鼻蝶窦入路手术切除后颅内感染率、相关危险因素及相关预防测量研究。方法选取2009年1月至2015年1月本院收治的垂体腺瘤患者396例,对性别、年龄、糖尿病病史、高血压病病史、手术时间、术中是否脑脊液漏、术中是否存在鞍隔破损、术中出血量、术后是否出现脑脊液漏、术后有无留置引流管、预防性应用抗菌药物以及术后应用激素等因素进行相关因素分析。结果 396例垂体腺瘤患者,术后颅内感染19例,感染率为4.7%;术后脑脊液漏、留置引流管和应用糖皮质激素是颅内感染的危险因素,而预防性应用抗菌药物是减少颅内感染的保护性因素(P均<0.05)。对颅内感染的危险因素行多因素Logistic回归分析结果显示,术后脑脊液漏、留置引流管、激素治疗及预防性抗菌药物应用仍与颅内感染明显相关,术后脑脊液漏、留置引流管以及激素治疗均为术后颅内感染的独立危险因素。结论减少术后脑脊液漏和及时修补、加强留置引流管护理、严格掌握术后糖皮质激素的应用指征,以及合理预防性应用抗菌药物可能会预防颅内感染的发生。
Objective To analyze the intracranial infection rate,related risk factors and related prevention analysis after transsphenoidal surgery in patients with pituitary adenoma.Methods Total of396cases with pituitary adenoma patients from January2009to January2015were collected.The sex,age,history of diabetes,hypertension,operative time,intraoperative cerebrospinal fluid leakage,whether the existence of the diaphragmatic damage,bleeding,or cerebrospinal fluid leakage,postoperative drainage,no prophylactic use of antibiotics,postoperative application of hormone were analyzed,respectively.Results Among the396cases with pituitary adenoma,19cases with postoperative intracranial infection,the infection rate was4.7%.Postoperative cerebrospinal fluid leakage,indwelling drainage tube and glucocorticoid were risk factors of intracranial infection,while prophylactic antibiotics was the protective factor of reducing intracranial infection(all P<0.05).The risk of intracranial infection after multiple factors Logistic regression analysis showed that the postoperative cerebrospinal fluid leakage,indwelling drainage tube,hormone therapy and prophylactic antibiotics application and intracranial infection were significantly correlated;postoperative cerebrospinal fluid leakage,indwelling drainage tube and hormone therapy were independent risk factors of postoperative intracranial infection.Conclusions Reduce postoperative cerebrospinal fluid leakage in operation,timely repair,strengthening the nursing of drainage tube indwelling operation,strict control of postoperative application of glucocorticoid indications,reasonable use of antibiotics could prevent the occurrence of intracranial infection.
作者
李冰
Li Bing(Department of Neurosurgery, The First People’s Hospital of Shangqiu, Shangqiu 476000,China)
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2017年第4期409-412,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
关键词
垂体腺瘤切除术
颅内感染
危险因素
预防策略
Pituitary adenoma
Risk factors of postoperative
Intracranial infection
Prevention strategies
