经鼻内镜颅底肿瘤切除术后颅内感染临床特征及危险因素分析

尹丽霞; 高婷; 钱海鹏; 刘燕; 陈宝敏

doi:10.3969/j.issn.1000-8179.2020.04.299

经鼻内镜颅底肿瘤切除术后颅内感染临床特征及危险因素分析

Risk factors and clinical characteristics of intracranial infection after endoscopic endonasal skull base surgery

摘要

摘要:
目的分析经鼻内镜颅底肿瘤切除术后颅内感染的危险因素，为预防感染提供依据。
方法选取2011年1月至2016年12月于中国医学科学院北京协和医学院肿瘤医院行经鼻内镜颅底肿瘤切除术（endoscopic endonasal skull base surgery，EESBS）患者共150例，收集患者一般信息、基础疾病信息、手术信息、术后信息、抗菌药物使用信息等，进行单因素及多因素Logistic分析。
结果 150例手术患者中27例发生颅内感染，感染率为18.0%；脑脊液培养结果阳性8例，阳性率为29.6%。27例颅内感染患者中18例（66.7%）发生脑脊液漏，脑脊液漏发生平均9.28天。23例患者（85.2%）术中脑室外引流或腰大池引流，22例患者（81.5%）颅底重建。经Logistic回归分析，未在术前0.5~1.0 h使用抗菌药物、术中脑室外引流或腰大池引流、术中颅底重建、BMI ≥ 25 kg/m2为颅内感染的独立危险因素。
结论本研究筛选EESBS患者术后发生颅内感染的独立危险因素，为实现颅内感染精准防控提供依据。

Abstract:
Objective To identify risk factors associated with intracranial infection after endoscopic endonasal skull base surgery.
Methods From January 2011 to December 2016, 150 patients who underwent endoscopic resection of a skull base tumor at the Chinese Academy of Medical Sciences Cancer Hospital (CAMS) were selected. Data related to general patient characteristics, underlying disease, type of operation, postoperative condition, and antimicrobial drug use, etc., were collected. The SPSS21.0 software was used to perform univariate and multivariate logistic analyses.
Results Of 150 patients, 27 had intracranial infection, and the infection rate was 18%. Logistic regression analysis revealed that no antimicrobial agents were used 0.5-1 h before the operation, external ventricular drain or lumbar drainage during operation, skull base reconstruction, and BMI ≥25 were independent risk factors for intracranial infection.
Conclusions Independent risk factors of intracranial infection after endoscopic resection of skull base tumors were screened. The results provide a basis for the accurate management of infection control at surgical sites.

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