Kinoshita Yasuyuki, Tominaga Atsushi, Saitoh Taiichi, Usui Satoshi, Takayasu Takeshi, Arita Kazunori, Sakoguchi Tetsuhiko, Sugiyama Kazuhiko, Kurisu Kaoru
Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan,
Neurosurg Rev. 2013 Nov 14. doi: 10.1007/s10143-013-0505-7.
The most common complication of neuroendoscopic surgery is postoperative fever without infection, although the details have not been discussed. The objective of this study was to clarify the clinical features and predicting factors of the postoperative fever following neuroendoscopic procedures. Between March 1998 and March 2013, 83 patients (46 males, 37 females; median age, 14.0 years) who had undergone surgery via the transventricular approach under a neuroendoscopic view were included in this study. A total of 86 neuroendoscopic procedures were performed in 83 patients. The incidence and duration of postoperative fever (≥38.0 and ≥39.0 °C) over the 7 days after surgery were examined. Moreover, the following variables predictive of fever were investigated: age, sex, neuroendoscopic procedure, operative time, and intraoperative irrigation fluid. The incidence of postoperative fever was 65.1 % (≥38.0 °C) and 15.1 % (≥39.0 °C). The median level of the highest fever was 38.6 °C. The fevers developed immediately after surgery and spontaneously disappeared within four postoperative days. Only age was related to postoperative fever (p = 0.032). The postoperative body temperature was negatively correlated with age in all 86 surgeries (p < 0.001, Spearman r = -0.396). In particular, patients under 10 years of age tended to have postoperative fever (p = 0.005). The result of this study demonstrated a peculiar pattern of fever following neuroendoscopic procedures. This type of fever did not cause serious problems; however, special attention should be paid to the high incidence of postoperative fever in patients under 10 years of age.
神经内镜手术最常见的并发症是术后无感染性发热，不过其细节尚未得到探讨。本研究的目的是阐明神经内镜手术后发热的临床特征及预测因素。1998年3月至2013年3月期间，本研究纳入了83例经神经内镜下经脑室入路进行手术的患者（男性46例，女性37例；中位年龄14.0岁）。83例患者共进行了86次神经内镜手术。对术后7天内术后发热（≥38.0℃和≥39.0℃）的发生率及持续时间进行了检查。此外，还研究了以下发热预测变量：年龄、性别、神经内镜手术、手术时间及术中冲洗液。术后发热的发生率为65.1%（≥38.0℃）和15.1%（≥39.0℃）。最高发热的中位水平为38.6℃。发热在术后即刻出现，并在术后4天内自行消退。只有年龄与术后发热相关（p = 0.032）。在所有86例手术中，术后体温与年龄呈负相关（p < 0.001，Spearman相关系数r = -0.396）。特别是10岁以下的患者术后更容易发热（p = 0.005）。本研究结果显示了神经内镜手术后发热的一种特殊模式。这种类型的发热不会导致严重问题；然而，对于10岁以下患者术后发热的高发生率应予以特别关注。
