颅脑肿瘤患者术后发热原因分析
|
摘要
目的探讨颅脑肿瘤患者术后发热的原因,为颅脑肿瘤患者术后发热的诊疗提供相关依据。方法选取行颅脑肿瘤手术的120例患者资料。所有颅脑肿瘤患者均符合中国临床肿瘤学会(CSCO)制定的《2018. V1版头颈部肿瘤诊疗指南》中的诊断标准,首次发病且入院前未行过开颅手术,无严重的肺、肝、肾功能不全,无颅外肿瘤、术前感染及自身免疫性疾病。以患者的腋窝温度大于37. 3℃为发热,将120例患者分为发热组和无发热组。分析发热组患者的血、尿、便、生化全项,心电图,胸片,头CT等实验室检查结果。比较发热组及无发热组患者的年龄、性别、手术时间、麻醉后复苏时间、手术并发症发生率的差异。结果本研究中发热组患者86例,占患者总数的71. 7%。其中中枢性高热38例(44. 2%),脱水热15例(17. 4%),吸收热14例(16. 2%),再出血热3例(0. 4%),颅内感染3例(3. 4%),肺部感染8例(9. 3%),其他部位感染5例(5. 8%)。发热组与非发热组患者的年龄、麻醉后复苏时间、手术时间及术后并发症发生率差异均有统计学意义(P <0. 05)。结论中枢性高热为颅脑肿瘤患者术后发热的主要原因,但感染等其他因素亦占有一定比例。尽量缩短手术时间、减少麻醉后复苏时间及避免术后并发症可以减少术后患者发热概率。
Objective To analyse the causes of fever in patients with craniocerebral tumor after operation.Methods The data of 120 patients who performed craniocerebral tumor surgery were randomly selected. All patients with craniocerebral tumors meet the diagnostic criteria in the Guidelines for the Diagnosis and Treatment of 2018. V1 Edition Neck Tumors Developed by the Chinese Society of Clinical Oncology( CSCO) : first onset and no craniotomy prior to admission,no severe lung,liver,renal insufficiency,no extra-cranial tumors,preoperative infections and autoimmune diseases. Taking the patient 's armpit temperature greater than 37. 3 ℃ as fever,120 patients were divided into fever Group and no Fever group. The results of blood,urine,stool,biochemical test,electrocardiogram,chest and head CT of the patients in the heating group were analyzed,and the proportion of the causes of fever was discussed. The differences of age,sex,operationtime,recovery time after anesthesia and incidence of surgical complications were compared among patients with fever group and no Fever group. Results 86 patients in the fever group accounted for 71. 7% of the total number of patients. Among them,38 cases of central hyperthermia( 44. 2%),15 cases of dehydration heat( 17. 4%),14 cases of absorption heat( 16. 2%),3 cases of hemorrhagic fever( 0. 4%),3 cases of intracranial infection( 3. 4%),8 cases of pulmonary infection( 9. 3%),and 5 cases of infection in other parts( 5. 8%). The comparison of age,postoperative resuscitation time,operation time and postoperative complication rate between the febrile group and the non-febrile group was statistically significant( P < 0. 05). Conclusions Central hyperthermia is the main cause of postoperative fever in patients with craniocerebral tumors,but other factors such as infection also accounts for a certain proportion. Minimizing the operation time,reducing the recovery time after anesthesia and avoiding postoperative complications can reduce the risk of fever for postoperative patients.
Objective To analyse the causes of fever in patients with craniocerebral tumor after operation.Methods The data of 120 patients who performed craniocerebral tumor surgery were randomly selected. All patients with craniocerebral tumors meet the diagnostic criteria in the Guidelines for the Diagnosis and Treatment of 2018. V1 Edition Neck Tumors Developed by the Chinese Society of Clinical Oncology( CSCO) : first onset and no craniotomy prior to admission,no severe lung,liver,renal insufficiency,no extra-cranial tumors,preoperative infections and autoimmune diseases. Taking the patient 's armpit temperature greater than 37. 3 ℃ as fever,120 patients were divided into fever Group and no Fever group. The results of blood,urine,stool,biochemical test,electrocardiogram,chest and head CT of the patients in the heating group were analyzed,and the proportion of the causes of fever was discussed. The differences of age,sex,operationtime,recovery time after anesthesia and incidence of surgical complications were compared among patients with fever group and no Fever group. Results 86 patients in the fever group accounted for 71. 7% of the total number of patients. Among them,38 cases of central hyperthermia( 44. 2%),15 cases of dehydration heat( 17. 4%),14 cases of absorption heat( 16. 2%),3 cases of hemorrhagic fever( 0. 4%),3 cases of intracranial infection( 3. 4%),8 cases of pulmonary infection( 9. 3%),and 5 cases of infection in other parts( 5. 8%). The comparison of age,postoperative resuscitation time,operation time and postoperative complication rate between the febrile group and the non-febrile group was statistically significant( P < 0. 05). Conclusions Central hyperthermia is the main cause of postoperative fever in patients with craniocerebral tumors,but other factors such as infection also accounts for a certain proportion. Minimizing the operation time,reducing the recovery time after anesthesia and avoiding postoperative complications can reduce the risk of fever for postoperative patients.
引文
[1]郑兴,袁莉.血清降钙素原(PCT)对ICU重度颅脑损伤患者发热原因的鉴别诊断价值分析[J].世界最新医学信息文摘:电子版,2016,16(15):78. DOI:10.3969/j. issn. 1671-3141. 2016. 15. 059.
[2]张丽,徐旭,赵珂,等.降钙素原和C反应蛋白对重型颅脑损伤患者发热原因的探讨[J].中国处方药,2017,16(6):1-2.
[3]许士海,单爱军,王进.中枢性发热的治疗与护理研究进展[J].中外医学研究,2018,16(3):173-175.
[4]苗艳天,窦永青,郝彦琴,等.感染性心内膜炎合并中枢神经系统感染延诊1例[J].中国现代医学杂志,2018,28(33):127-128.
[5]曹静,玄静,马晶.颅脑损伤患者发热物理降温方法及疗效[J].中国实用医药,2012,7(29):222-223.
[6]黄锦. 200例高血压脑出血患者术后发热的相关因素分析与对策[J].湖北科技学院学报(医学版),2018,32(5):397-399.
[7]金涌,刘池波,罗永康,等.神经外科患者医院感染的临床分析[J].中华医院感染学杂志,2010,20(5):644-645.
[8]郑一,徐明,王谦,等.神经外科患者医院获得性感染的发病与构成分析[J].北京医学,2008,44(5):267-269.
[9] HUANG H,HUANG S Y,ZHU P L,et al. Continuous versus intermittent infusion of cefepime in neurosurgical patients with post-operative intracranial infections[J]. Int J Antimicrob Ag,2014,43(1):68-72.
[10]国家卫生和计划生育委员会,《中国结直肠癌诊疗规范(年版)》专家组.中国结直肠癌诊疗规范(2017年版)[J].中华临床医师杂志:电子版,2018,12(1):3-23. DOI:10. 3877/cma. j. issn. 1674-0785. 2018. 01. 003.
[11]高成山,金辉.心脏瓣膜置换术后精神障碍发生原因分析[J].江苏医药,2010,36(9):1048-1049.
[12]臧运香,王娟.心脏瓣膜置换术后心理变化原因分析、护理及体会[J].中国实用医药,2013,8(1):205-206.
[2]张丽,徐旭,赵珂,等.降钙素原和C反应蛋白对重型颅脑损伤患者发热原因的探讨[J].中国处方药,2017,16(6):1-2.
[3]许士海,单爱军,王进.中枢性发热的治疗与护理研究进展[J].中外医学研究,2018,16(3):173-175.
[4]苗艳天,窦永青,郝彦琴,等.感染性心内膜炎合并中枢神经系统感染延诊1例[J].中国现代医学杂志,2018,28(33):127-128.
[5]曹静,玄静,马晶.颅脑损伤患者发热物理降温方法及疗效[J].中国实用医药,2012,7(29):222-223.
[6]黄锦. 200例高血压脑出血患者术后发热的相关因素分析与对策[J].湖北科技学院学报(医学版),2018,32(5):397-399.
[7]金涌,刘池波,罗永康,等.神经外科患者医院感染的临床分析[J].中华医院感染学杂志,2010,20(5):644-645.
[8]郑一,徐明,王谦,等.神经外科患者医院获得性感染的发病与构成分析[J].北京医学,2008,44(5):267-269.
[9] HUANG H,HUANG S Y,ZHU P L,et al. Continuous versus intermittent infusion of cefepime in neurosurgical patients with post-operative intracranial infections[J]. Int J Antimicrob Ag,2014,43(1):68-72.
[10]国家卫生和计划生育委员会,《中国结直肠癌诊疗规范(年版)》专家组.中国结直肠癌诊疗规范(2017年版)[J].中华临床医师杂志:电子版,2018,12(1):3-23. DOI:10. 3877/cma. j. issn. 1674-0785. 2018. 01. 003.
[11]高成山,金辉.心脏瓣膜置换术后精神障碍发生原因分析[J].江苏医药,2010,36(9):1048-1049.
[12]臧运香,王娟.心脏瓣膜置换术后心理变化原因分析、护理及体会[J].中国实用医药,2013,8(1):205-206.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |