Chiari畸形Ⅰ型经神经内镜下后颅窝减压术后发热原因探讨及技术改进

Objective: To investigate the infectious and non-infectious factors of postoperative fever in patients with type Ⅰ posterior fossa decompression of Chiari malformation and to explore corresponding surgical improvement measures to reduce postoperative fever. Methods: We retrospectively analyzed the clinical data of 14 patients with Chiari malformation type Ⅰ posterior fossa decompression treated in The First Affiliated Hospital of Xi'an Jiaotong University during March 2018 and March 2019. We compared the incidence of postoperative fever and hospitalization duration and cost between the two groups. Results: Among the 14 included patients, 7 of them were treated with the traditional suture technique, and all of them had postoperative epidural effusion and fever. Three of them were confirmed to have central nervous system infection. After application of our self-developed and innovative dural muscle suspension suture method on seven patients, no postoperative effusion and fever occurred. All the patients were cured and discharged from the hospital. Compared with the traditional suture group, the improved suture group had a lower hospitalization cost and shorter hospitalization time (P<0.050, P<0.050). Conclusion: Non-infectious factors, especially epidural effusion, may be the main cause of postoperative fever in patients with Chiari malformation type I posterior fossa decompression, which can be minimized by dural muscle suspension suture.