摘要：

目的 筛查颅底肿瘤开颅手术后颅内感染的相关危险因素。方法 回顾分析2010年5月至2020年1月在安徽医科大学第二附属医院行开颅颅底肿瘤切除术的159例患者临床资料，单因素和多因素前进法Logistic回归分析筛查术后颅内感染相关危险因素。结果 159例患者中81例发生术后颅内感染，颅内感染率为50.94%。Logistic回归分析显示，手术时间≥ 5 h（OR=3.438，95% CI：1.371~8.625；P=0.008）、术中失血量≥ 400 ml（OR=2.308，95% CI：1.115~4.777；P=0.024）、术中开放额窦或乳突气房（OR=16.817，95% CI：3.689~76.658；P=0.000）是颅底肿瘤开颅手术后颅内感染的危险因素。结论 手术时间长、术中失血多、术中开放额窦或乳突气房的颅底肿瘤患者开颅手术后发生颅内感染的风险较高，应采取有效的防控措施降低颅内感染率。

关键词: 颅底肿瘤, 神经外科手术, 感染, 危险因素, Logistic模型

Abstract:

Objective To analyze the relevant risk factors for intracranial infection after craniotomy for resection of skull base neoplasms. Methods The clinical data of 159 patients with skull base neoplasms who underwent craniotomy from May 2010 to January 2020 in The Second Affiliated Hospital of Anhui Medical University were analyzed retrospectively. The relevant risk factors for intracranial infection were analyzed by univariate and multivariate forward Logistic regression. Results Postoperative intracranial infection occurred in 81 out of 159 patients, the infection rate was 50.94%. Multivariate forward Logistic regression analysis showed the operation time was ≥ 5 h (OR=3.438, 95%CI: 1.371-8.625; P=0.008), blood loss ≥ 400 ml (OR=2.308, 95%CI: 1.115-4.777; P=0.024), frontal sinus or mastoid air chamber breach (OR=16.817, 95%CI: 3.689-76.658; P=0.000) were the risk factors for intracranial infection after craniotomy for resection of skull base neoplasms. Conclusions There was a higher risk of intracranial infection after craniotomy for resection of skull base neoplasms in patients who had long operation time, more intraoperative blood loss as well as frontal sinus or mastoid air chamber breach. It is necessary to adopt effective prevention and control measures to reduce the risk of intracranial infection.

Key words: Skull base neoplasms, Neurosurgical procedures, Infection, Risk factors, Logistic models