垂体腺瘤经鼻蝶入路神经内镜切除术后颅内感染的危险因素

目的 探讨垂体腺瘤经鼻蝶入路神经内镜切除术后发生颅内感染的危险因素。方法 回顾性分析2016年12月至2020年10月间经鼻蝶入路神经内镜手术切除的652例垂体腺瘤的临床资料，采用多因素logistic回归模型分析术后发生颅内感染的危险因素。结果 652例中，20例术后发生颅内感染，发生率为3.07%。多因素logistic回归分析显示，CSF漏(OR=5.845; 95% CI 1.334~25.613; P=0.019)、腰大池引流（OR=8.382；95% CI 1.807~38.874；P=0.007）、肿瘤直径>2 cm（OR=11.797；95% CI 1.395~99.727；P=0.023）、手术时间>3 h（OR=4.286；95% CI 1.005~18.279；P=0.049）、多次手术（OR=10.127；95% CI 1.334~25.613；P=0.019）、术后使用激素（OR=4.518；95% CI 1.301~15.686；P=0.018）是术后发生颅内感染的独立危险因素。结论 PA病人术后发生颅内感染，严重影响病人预后和手术效果；早期识别颅内感染的危险因素，采取适当的预防措施，对减少PA病人经鼻蝶入路神经内镜切除术后颅内感染，尤为重要。

Risk factors for intracranial infection in patients with pituitary adenoma after endoscopic transsphenoidal surgery

Objective To analyze the risk factors for intracranial infection in the patients with pituitary adenoma (PA) after endoscopic transsphenoidal surgery (ETS). Methods The clinical data of 652 patients with PA who underwent ETS from December 2016 to October 2020 were retrospectively analyzed. The risk factors of intracranial infection were analyzed by multivariate logistic regression. Results The incidence of intracranial infection was 3.07% (20/652). Multivariate logistic regression analysis showed that cerebrospinal fluid leakage (OR=5.845; 95% CI 1.334~25.613; P=0.019), lumbar cistern drainage (OR=8.382; 95% CI 1.807~38.874; P=0.007), tumor diameter>2 cm (OR=11.797; 95% CI 1.395~99.727; P=0.023), operation time>3 h (OR=4.286; 95% CI 1.005~18.279; P=0.049), secondary operation (OR=10.127; 95% CI 1.334~25.613; P=0.019), and postoperative hormone use (OR=4.518; 95% CI 1.301~15.686; P=0.018) were independent risk factors for intracranial infection. Conclusions Postoperative intracranial infection has a serious impact on the prognoses and surgical outcomes of patients with PA. Early identification of risk factors for intracranial infection and appropriate preventive measures are essential for reducing intracranial infection in the patients with PA after ETS.