Risk Factors Of Intracranial Infection After Endoscopic Nasal Pituitary Tumor Surgery

Objective:Pituitary tumor is a common benign tumor in sella region.Its clinical manifestations are mainly caused by tumor occupying effect and endocrine dysfunction.Except prolactinoma,other types of tumors are mainly resected surgically.With the development of microsurgery,neuroendoscopic transsphenoidal approach for pituitary tumor resection is increasingly applied in clinical practice.Intracranial infection is one of the common complications after pituitary tumor surgery,which can cause high disability and death rate to patients and become a thorny problem for neurosurgeons.The purpose of this study is to analyze the incidence,risk factors and prevention strategies of intracranial infection after neurosurgery pituitary tumor resection via transsphenoidal approach in our hospital,and to provide help for prevention and treatment of postoperative intracranial infection,so as to reduce the occurrence of postoperative intracranial infection and improve the living standard of patients.Methods:From January 2017 to December 2019,230 patients undergoing pituitary tumor resection via transsphenoidal approach in our department were selected as the research objects for retrospective study and analysis.The recorded data include the patient's basic information(gender,age),body mass index,intraoperative blood loss,intraoperative and postoperative cerebrospinal fluid leakage,operation time,tumor size and previous medical history(diabetes,hypertension),etc.The data were analyzed by SPSS21.0 software for single factor and multiple factor analysis(p <0.05).it is believed that the correlation between related factors and intracranial infection is statistically significant.Results:Among 230 patients who underwent pituitary tumor resection via endoscopic transsphenoidal approach,16 patients suffered intracranial infection after surgery,with an infection rate of 6.9%.Univariate analysis showed that intraoperative hemorrhage ?120ml,cerebrospinal fluid leakage,diabetes mellitus,BMI and operation time ?4h were the risk factors for intracranial infection after endoscopic transsphenoidal pituitary tumor resection(P < 0.05),with statistically significant differences.Logistic regression equation was used to analyze multiple factors.The results showed that the volume of tumor,body mass index of patients,intraoperative blood loss and intraoperative cerebrospinal fluid leakage were independent risk factors for postoperative intracranial infection.Conclusion :1.Univariate analysis found that during and after transsphenoidal pituitary tumor resection,cerebrospinal fluid leakage,body mass index of the patient,volume of pituitary tumor,patient's history of diabetes and intraoperative blood loss were related to the risk of intracranial infection after surgery.2.logistic multivariate analysis found that tumor volume,body mass index,intraoperative blood loss and intraoperative cerebrospinal fluid leakage were independent risk factors for postoperative intracranial infection.3.Pay enough attention to the above risk factors during perioperative period and take effective and reasonable measures to reduce the occurrence of intracranial infection after pituitary tumor resection via transsphenoidal approach and improve the living standard of patients.