摘要
目的分析神经内镜下经鼻蝶窦入路垂体瘤切除术后颅内感染危险因素。方法回顾性分析2016年9月-2019年9月武汉市武昌医院行神经内镜下经鼻蝶窦入路垂体瘤切除术的100例垂体瘤患者,按术后是否发生颅内感染分为感染组、未感染组,比较其临床资料,采用免疫组化SP法测定垂体瘤组织中[垂体瘤转化基因(PTTG)、黏蛋白1(MUC1)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-12],分析导致颅内感染的危险因素。结果100例垂体瘤患者共10例术后发生颅内感染,感染患者共分离培养出病原菌8株,其中革兰阴性菌5株,革兰阳性菌3株;患者年龄≥60岁、合并糖尿病、肿瘤直径≥3 cm、肿瘤类型为生长激素型,PTTG蛋白、MUC1蛋白、TNF-α、IL-12阳性、手术时间≥4 h、术中出血量≥150 ml、术中脑脊液漏、术中鞍膈破损、术后3 d应用激素、术后转ICU、术后置管引流、术前预防性应用抗菌药物、术后接受综合护理均是颅内感染的影响因素(均P<0.05),多因素分析结果显示,手术时间为导致垂体瘤切除术后颅内感染的独立危险因素(P<0.05)。结论鼻蝶窦入路垂体瘤切除术后颅内感染风险高,对于手术时间长患者应重点预防。
OBJECTIVE To analyze the risk factors for postoperative intracranial infection in the patients undergoing neuroendoscopic resection of pituitary adenoma through a transsphenoidal approach.METHODS Totally 100 patients with pituitary adenoma who underwent neuroendoscopic resection of pituitary adenoma through a transsphenoidal approach in Wuhan Wuchang Hospital from Sep 2016 to Sep 2019 were retrospectively analyzed and divided into the infection group and the non-infection group according to the status of postoperative intracranial infection.The clinical data were compared between the two groups,the expression levels of pituitary tumor transforming gene(PTTG),mucin 1(MUC1),tumor necrosis factor-α(TNF-α),interleukin(IL)-6 and IL-12 in pituitary tumor tissues were detected by using immunohistochemical SP method,and the risk factors for the intracranial infection were analyzed.RESULTS Among the 100 pituitary adenoma patients,10 had postoperative intracranial infection.A total of 8 strains of pathogens were isolated from the patients with infection,5 of which were gram-negative bacteria,and 3 were gram-positive bacteria.The influencing factors for the intracranial infection included the no less than 60 years of age,complication with diabetes mellitus,diameter of tumor no less than 3 cm,growth hormone-type tumor,positive PTTG protein,MUC1 protein,TNF-αand IL-12,operation duration no less than 4 hours,intraoperative blood loss volume no less than 150 ml,intraoperative cerebrospinal fluid leakage,intraoperative saddle septum damage,use of hormone after surgery for 3 days,transfer to ICU after surgery,postoperative catheter indwelling drainage,preoperative prophylactic use of antibiotics and postoperative comprehensive care(all P<0.05).Multivariate analysis showed that the operation duration was the independent risk factor for the postoperative intracranial infection in the patients undergoing resection of pituitary adenoma(P<0.05).CONCLUSION The patients undergoing resection of pituitary adenoma through a transsphenoi
作者
张芬芳
陈静芳
张颖
王卉
吕刚
ZHANG Fen-fang;CHEN Jing-fang;ZHANG Ying;WANG Hui;LYU Gang(Wuhan Wuchang Hospital,Wuhan,Hubei 430063,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第14期2174-2178,共5页
Chinese Journal of Nosocomiology
基金
武汉市卫计委基金资助项目(WX16B16)。
关键词
垂体瘤切除术
颅内感染
危险因素
Resection of pituitary adenoma
Intracranial infection
Risk factor
