Analysis Of Risk Factors Of Intracranial Infection After Transsphenoidal Pituitary Adenoma Surgery And Comparison Of Safety Between Endoscopic Surgery And Microscopic Surgery

Objective:To study the distribution of intracranial infection in patients with pituitary adenoma after transsphenoidal resection,analyse the risk factors of postoperative intracranial infection and compare of the safety of endoscopic and microscopic surgery,provide a basis for clinical prevention of postoperative intracranial infection.Methods:690 patients with transnasal transsphenoidal pituitary adenoma who underwent adenomaresection in Tianjin Huanhu Hospital in January 2014 to December 2017 were studied.The clinical data of all patients were collected,including the history of the disease,the classification of the tumor,the preoperative and postoperative indexes,and the operation conditions.The patients were divided into the infection group and the uninfected group according to the diagnostic criteria of postoperative intracranial infection.Based on the review and clinical experience,use the SPSS 22.0 software to Logistic retrospective analysis the single factor and multiple factor,and to discuss the related indexes.The patients were divided into endoscopic and microscope groups according the operative method.The clinical data of the two groups were analyzed on the basis of the previous research results and clinical experience,and the safety of the two surgical procedures was further evaluated.Results:The incidence of postoperative intracranial infection in 690 patients was6.09%(42 cases).Operation time > 4 hours,postoperative cerebrospinal fluid leakage,prophylactic use of antimicrobial agents were the risk factors of postoperative intracranial infection(P < 0.05).Age,history of diabetes,pathological type of the tumor,and size of the tumor had no significant influence on the postoperative infection.The time of endoscopic surgery and the leakage rate of cerebrospinal fluid after operation were higher than that of microscope(P < 0.05).There was no significant difference in the infection rate between the two groups in the case of the use of antibiotic prophylaxis,and in the absence of antibiotic prophylaxisthe the infection rate after endoscopic surgery was higher than that of the microscope(P <0.05).The total resection rate of tumour of endoscopes was higher(P < 0.05).Conclusion:The principle of asepsis should be strictly followed in transsphenoidal surgery.Close observation and careful skull base repair should be performed during operation and surgical exposure time should be minimized.Infection patients should be closely observed and infection should be timely controlled.The operation time of the microscope is shorter and the cerebrospinal fluid leakage rate is lower;endoscopic surgery has a higher rate of total resection,especially for larger tumors.Under strict prophylactic use of antibiotics,the two surgical methods had similar postoperative infection rates,and all of them were safe.Prophylactic antimicrobial agents have a more pronounced effect for endoscopic surgery on reducing postoperative intracranial infection rate.