神经内镜下经鼻蝶垂体瘤切除术后脑脊液漏的危险因素分析

Risk Factors of Cerebrospinal Fluid Leakage after Neuroendoscopy Endonasal Transsphenoidal Resection of Pituitary Adenomas

摘要: 目的：探讨神经内镜下经鼻蝶内镜治疗垂体腺瘤手术后发生脑脊液漏的危险因素。方法：对2018年11月~2023年11月在深圳市人民医院神经外科接受经鼻蝶内镜治疗垂体腺瘤的168名患者进行回顾性分析，应用单因素分析法筛选出病人术后并发脑脊液漏的可能影响因素，并行Logistic回归分析确定独立危险因素。结果：168名患者中发生术后脑脊液漏的患者5例(2.98%)，单因素分析显示：是否重复手术、术中脑脊液漏、病理类型与术后并发脑脊液漏有关(P < 0.05)。多因素Logistic回归分析显示，是否重复手术和术中脑脊液漏为病人术后并发脑脊液漏的独立危险因素(P < 0.05)。结论 重复手术和术中脑脊液漏是经鼻蝶垂体瘤切除术后发生脑脊液漏的独立危险因素。

Abstract: Objective: To investigate the risk factors of cerebrospinal fluid leakage after transsphenoidal endoscopic pituitary adenoma surgery. Methods: A retrospective analysis was conducted on 168 patients who underwent endonasal transsphenoidal endoscopic treatment of pituitary adenomas in the Department of Neurosurgery, Shenzhen People’s Hospital from November 2018 to November 2023. Univariate analysis was used to screen out the possible influencing factors of postoperative cerebrospinal fluid leakage, and Logistic regression analysis was used to determine the independent risk factors. Results: Among 168 patients, 5 patients (2.98%) had postoperative cerebrospinal fluid leakage. Univariate analysis showed that repeated surgery, intraoperative cerebrospinal fluid leakage and pathological type were related to postoperative cerebrospinal fluid leakage (P < 0.05). Multivariate Logistic regression analysis showed that repeated surgery and intraoperative cerebrospinal fluid leakage were independent risk factors for postoperative cerebrospinal fluid leakage (P < 0.05). Conclusions: Repeat surgery and intraoperative CSF leakage are independent risk factors for CSF leakage after transsphenoidal pituitary tumor resection.