目的分析颅底肿瘤经硬膜下入路术后发热的相关因素。方法收集经硬膜下入路治疗的103例颅底肿瘤病人的临床资料。结果Ⅰ类切口17例,Ⅱ类切口86例,手术时间平均(5.5±2.0)h,出血量平均(923.8±819.8)ml。住院时间平均(12.4±4.0)d。体温正常组22例,发热组81例。发热病人在术后第1天和第7天人数最多(P〈0.05)。Logistic回归分析显示:术后发热与手术出血量有关(P=0.003),而与性别、年龄、既往手术史、手术切口、手术时间、管床医师级别无关(P〉0.05)。结论对于术中出血多的颅底肿瘤术后发热的可能性大,应该早期行腰椎穿刺治疗,这样会缩短住院时间,减少病人痛苦。
Objective To analyze the factors related to fever after skull base tumor surgery via subdural approach. Methods A series of 103 skull base tumor patients undergoing surgery via subdural approach was included. Results Type I incision was performed in 17 patients and type Ⅱ in 86. The mean surgery time was (5.5 ± 2.0) h, and mean amount of bleeding was (923.8 ± 819.8) ml. The mean duration of hospital stays was (12.4 ±4.0) d. The normal temperature group included 22 patients, and fever group 81. The peak numbers of fever patients after skull base surgery were at the 1st and 7th day (P 〈 0.05). Logistic regression analysis showed that postoperative fever was related with the amount of bleeding (P = 0.003), but had no relationship with gender, age, surgery history, incision, surgery time and grade of clinician (P 〉 0.05). Conclusions For the skull base tumor patients with much bleeding during surgery, the possibility of fever is high and lumbar puncture should be performed in early stage for reducing the length of stay and decreasing patient suffering.