231例开颅患者术后发热的成因探讨

为了探讨开颅患者手术后发热、尤其是湿热发热的成因。在记录手术前 3d、术后 1～ 7d症状、舌脉的同时 ,着重观察术后用药及输液量。比较术后发热分别与季节、年龄、性别、原发病之间的关系 ;比较春、夏、秋冬季湿热发热所占比例以及湿热发热与非湿热发热的体温和补液量的差异。结果各季节术后发热均超过 5 0 % ,季节之间发热百分比无显著性差异 (P >0 0 5 ) ;2 0岁以下开颅患者发热率高 (P <0 0 5 ) ;男女性别发热率无显著性差异 (P >0 0 5 ) ;不同原发病中胶质瘤术后发热多于脑膜瘤 (P <0 0 5 )。湿热发热占发热总数的 75 % ,四季中秋冬季略少于春夏季 ,但无显著性差异 (P >0 0 5 ) ;湿热发热较非湿热发热补液偏多 ,有差异趋势 (P <0 2 ) ;体温明显高于非湿热发热 (P <0 0 5 )。发热是开颅术后常见的并发症 ,与季节、性别无关 ,与年龄、原发病有显著关系。湿热是术后发热的主要证型 ,湿热的形成与术后脾胃功能低下、用药及补液有一定关系

Study of the Causes of Postoperative Fever of 231 Patients with Craniotomy

Patients with craniotomy were involved in the study on the causes of postoperative fever (PF), especially PF of damp heat type. The factors of the drug administration, volume of fluid infusion, seasons, age, sex, primary disease, and the body temperature were taken into consideration in the study. The results showed that the morbidity of PF was above 50% in all the four seasons and there was no significant difference between any of two seasons ( P >0 05); the morbidity of PF was higher in the patients below the age of 20 ( P <0 05); there was no significant difference between the morbidity of PF in the male patients and that in the female ones ( P >0 05); the morbidity of PF was higher in the patients with glioma than that in the patients with meningioma ( P <0 05); the cases of PF of damp heat type accounted for 75% of all the cases of PF, among which, the morbidity was a little lower in autumn and winter than that in spring and summer, but without significant difference ( P >0 05); the volume of fluid infusion received by the patients with PF of damp heat type was larger than that received by the patients with PF ( P <0 20); and the body temperature of the patients with PF of damp heat type was significantly higher than that of the patients with PF ( P <0 05).