Risk Factors Analysis Of Intracranial Infection After Pituitary Tumor Resection By Transnasal Transsphenoidal Approach

Objective: The purpose of this study was to analyze the risk factors of intracranial infection after transsphenoidal pituitary tumor resection,and to provide some prevention and treatment guidance and coping strategies for the preoperative,intraoperative and postoperative management of such patients.Methods: To retrospectively analyze the clinical data（clinical data complete）of the patients who underwent transsphenoidal pituitary tumor resection in the Department of Neurooncology of The First Hospital of Jilin University from July 2020 to July 2021.The clinical data collected include:gender,age,preoperative albumin,operation time,whether prophylactic use of antibiotics before or during operation,history of diabetes,history of hypertension,history of sinusitis,history of operation（craniotomy or nasal surgery）,cerebrospinal fluid leakage after operation,postoperative steroid use,drainage of lumbar cistern,tumor diameter,pathological type,pulmonary infection and so on.Univariate analysis and multivariate logistic analysis were carried out to find out the factors and degree related to intracranial infection after transsphenoidal pituitary adenoma surgery.Results: There were 15 cases of intracranial infection in 440 patients with transnasal pituitary adenoma,and the infection rate was 3.41%.Tumor diameter（whether ≥ 3cm）,operation time（whether ≥ 2H）,history of hypertension,history of sinusitis,whether lumbar cistern drainage was performed during or after operation,whether cerebrospinal fluid leakage and pulmonary infection were all possible influencing factors of intracranial infection（P < 0.05）.Patient’s gender,age,preoperative albumin,whether prophylactic use of antibiotics before or during operation,history of diabetes,history of operation（craniotomy or nasal surgery）,postoperative steroid use,and pathological type had no significant effect on postoperative intracranial infection.Multivariate analysis of logistic regression equation showed that lumbar cistern drainage,cerebrospinal fluid leakage,tumor diameter ≥ 3cm and pulmonary infection were independent risk factors for intracranial infection after transsphenoidal pituitary tumor resection（P < 0.05）.Conclusion:（1）The independent risk factors of intracranial infection after transsphenoidal pituitary tumor resection were tumor diameter ≥ 3cm,lumbar cistern drainage during or after operation,postoperative cerebrospinal fluid leakage and pulmonary infection.（2）Preoperative evaluation should be done according to the above factors before operation.The operation should reduce the injury as much as possible.After operation,it should avoid lying in bed for a long time and closely observe whether there are clinical symptoms such as cerebrospinal fluid leakage.