Analysis Of Factors Affecting Intracranial Infection And Preventive Treatment Measures After Cerebellopontine Angle Tumor Resection

Objective: Analysis of intracranial infection in patients with tumors in the cerebellopotine angle region after retromastoid craniotomy approach in the Department of Neuro-Oncology,First Hospital of Jilin University,to study the influencing factors leading to intracranial infection after cerebellopotine angle region tumor resection,and to provide methods for the diagnosis,treatment and prevention of intracranial infection after cerebellopotine angle region tumor resection.Methods: Clinical data related to 224 patients who underwent the first posterior sigmoid sinus access tumor resection in the pontocerebellar horn region from September 2019 to September 2021 in the Department of Neuro-Oncology,First Hospital of Jilin University were collected and retrospectively analyzed.Patient information was collected detailedly,including general information（gender,smoking,alcohol consumption）,basic surgical information（duration of surgery,cerebrospinal fluid leak,intraoperative bleeding >400 ml,destruction of mastoid air spaces,type of pathology）,underlying disease（presence of diabetes mellitus,hypertension）,general condition during the course of the disease（presence of hypoalbuminemia,number of days in hospital in relation to the duration of lumbar cistern drainage placement）.Applying SPSS25.0 software,single factor analysis was performed considering the above factors affecting intracranial infection,and logistic and then multi-factor analysis was applied to the statistically significant single factors,with P < 0.05 being statistically significant.Patients with intracranial infection were divided into two categories according to whether the time of retention was the day of surgery or not.The effect of the time of placement of lumbar pool drainage on the number of days of hospitalization in patients with intracranial infection was analyzed by applying relevant statistical methods.Results: Of the 224 patients meeting the inclusion and exclusion criteria in this study for tumor resection in the pontocerebellar horn region,110 developed postoperative intracranial infection with an infection rate of 49.1%.Univariate statistical analysis: length of surgery >4 hours（P=0.007）,having underlying diabetes（P<0.001）,postoperative cerebrospinal fluid leak（P=0.001）,intraoperative bleeding >400 ml（P=0.015）,and destruction of mastoid airspace（P=0.002）were all associated with postoperative intracranial infection（P<0.05）;while type of pathology（P=0.518）,hypertension（P=0.158）,gender（P=0.958）,smoking（P=0.241）,alcohol consumption（P=0.388）,and hypoproteinemia（P=0.435）were unassociated with postoperative intracranial infection（P>0.05）.Statistically significant single factors were then subjected to multifactorial analysis by applying logistic,and the duration of surgery >4 hours,having underlying diabetes,postoperative cerebrospinal fluid leakage,intraoperative bleeding >400 ml,and destruction of the mastoid airspace were remained as independent risk factors for this study.Placement of lumbar pool drainage on the day of surgery may reduce the number of days patients stay in the hospital.Conclusion: 1.In this study,operative duration >4 hours,diabetes mellitus,cerebrospinal fluid leakage,papillary airspace opening,and intraoperative bleeding >400 ml were independent risk factors for the development of intracranial infection after tumor resection in the pontocerebellar horn region.Gender,type of pathology,smoking,hypertension,alcohol consumption,and hypoproteinemia were unassociated with the development of intracranial infection after tumor resection in the cerebellopotine angle region.2.In this study,some preventive measures were provided for the risk factors of intracranial infection after resection of tumor in cerebellopontine Angle.Under the premise that security is guaranteed to shorten the operation time,perioperative diabetes need to control blood sugar,in reducing blood loss during operation,cerebrospinal fluid leakage is found to give correct treatments including extraction effusion or surgical repair,preoperative complete fully the gasification intensity of the mastoid air cells in open the mastoid air cells need to repair in time.3.Patients with intracranial infections who had preoperative lumbar cistern drainage had shorter hospitalization days than those who did not have preoperative lumbar cistern drainage,indicating that the earlier lumbar cistern drainage were placed,the shorter the hospitalization days of patients with intracranial infections.It is recommended to indent lumbar cistern drainage tube before surgery to reduce the length of hospital stay of patients with intracranial infection.