中国垂体腺瘤患者经鼻蝶入路术后并发颅内感染危险因素的Meta分析  

Risk factors for postoperative intracranial infection in Chinese pituitary adenoma patients with endonasal transsphenoidal approach:a Meta-analysis

作　　者：张腊婷 姜雪 韩琳 ZHANG Lating;JIANG Xue;HAN Lin(School of Nursing,Shaanxi University of Chinese Medicine,Xianyang 712046,Shaanxi Province,China;Department of Neurosurgery,The Second Affiliated Hospital of Air Force Medical University,Xi'an 710038,China;Office of Infection Management,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi Province,China)

机构地区：[1]陕西中医药大学护理学院,陕西咸阳712046 [2]空军军医大学唐都医院神经外科,西安710038 [3]陕西中医药大学附属医院感染管理办公室,陕西咸阳712000

出　　处：《医学新知》2025年第2期211-221,共11页New Medicine

基　　金：空军综合研究科学研究项目一般项目(KJ2023C0KYD03)。

摘　　要：目的系统评价我国经鼻蝶入路垂体腺瘤切除术后并发颅内感染的发生率和危险因素。方法计算机检索Web of Science、PubMed、Cochrane Library、Embase、万方、中国知网、中国生物医学文献数据库、维普数据库中关于我国经鼻蝶入路垂体腺瘤切除术后并发颅内感染危险因素的研究。检索时限为建库至2024年12月。采用Stata 16.0软件对纳入文献进行Meta分析。结果纳入文献37篇,共12792例患者,颅内感染的发生率为7.4%[95%CI(6.0%,8.8%)]。Meta分析结果显示Kelly分级>2级、术中鞍隔破损、二次手术、肺部感染、术中及术后合并脑脊液漏、颅内积气、生长激素瘤、手术时间>1 h、术后留置引流管、术前使用激素、术中出血>120 mL、合并糖尿病、肿瘤长径>3 cm是发生颅内感染的危险因素,术前使用抗菌药物为保护因素。结论临床医务人员应针对颅内感染的影响因素对患者进行评估,对于高危患者可在术前应用抗菌药物,并及时采取相关措施以减少经鼻蝶入路垂体腺瘤切除术后颅内感染的发生。Objective To systematically evaluate the risk factors associated with intracranial infections complicating pituitary adenomas resection by transsphenoidal approach.Methods Web of Science,PubMed,Cochrane Library,Embase,Wanfang,CNKI,China Biomedical Literature Database, and VIP database were searched for studies about the risk factors of intracranial infectionscomplicating pituitary adenomas resection with transsphenoidal approach in Chinese patients with pituitarytumors. The search time was from inception to December 2024. Meta-analysis was performed using Stata 16.0software. Results A total of 37 literatures were included with 12,792 patients involved. The incidence rate ofintracranial infections was 7.4%[95%CI(6.0%, 8.8%)]. Meta-analysis showed that Kelly grade>2, intraoperativedamage to the diaphragma sellae, secondary surgery, pulmonary infection, intraoperative and postoperativecerebrospinal fluid leakage, intracranial pneumatosis, growth hormone-secreting adenoma, operation time>1 h,postoperative indwelling drain, preoperative hormone use, intraoperative bleeding>120 mL, comorbid diabetesmellitus, and tumor length diameter>3 cm were the risk factors for intracranial infection. Preoperative use ofantimicrobial drugs was a protective factor. Conclusion It is necessary for clinical staff to evaluate patientsundergoing transsphenoidal pituitary adenoma resection based on the influencing factors of intracranialinfection. For high-risk patients, antibiotics can be used before surgery, and timely measures should be taken toreduce the occurrence of intracranial infection after pituitary adenomas resection with transsphenoidal approach.

关 键 词：垂体腺瘤 经鼻蝶入路垂体腺瘤切除术 颅内感染 发生率 危险因素 META分析 

分 类 号：R739.41[医药卫生—肿瘤]