目的:探讨神经外科手术中额窦开放方式对患者术后发生中枢神经系统(CNS)感染的影响。方法:回顾性分析2007年1月至2019年12月山西医科大学第一医院神经外科术中行额窦开放的159例患者的临床资料。所有患者中，77例术中行额窦黏膜剔除、35例行额窦内壁电灼、7例行额窦内壁骨质打磨、96例行额窦填塞、159例行骨蜡封闭额窦、95例行带蒂骨膜瓣覆盖额窦。术后根据患者的临床症状、脑脊液、血细胞等实验室检查结果，综合判断患者是否发生CNS感染。采用单因素和多因素logistic回归分析法判断术中额窦开放方式是否为患者术后发生CNS感染的独立危险因素。结果:159例患者术中额窦开放的中位面积为95.9 mmn 2(11.8～706.6 mmn 2)，手术时长为(6.3±1.9)h。术后34例(21.4%)诊断为CNS感染，另125例(78.6%)未发生感染。单因素分析结果显示，性别、切开硬膜前处理额窦、额窦开放面积、手术时长、引流管放置及引流管放置时间是患者术后发生CNS感染的影响因素(均n P7 h(n OR＝2.935，95%n CI：1.143～7.535，n P＝0.025)、额窦开放面积≥95.9 mmn 2(n OR＝3.767，95%n CI：1.418～10.007，n P＝0.008)及引流管放置时间>1 d(n OR＝3.152，95%n CI：1.193～8.327，n P＝0.021)是患者术后发生CNS感染的独立危险因素，而切开硬膜前封闭额窦(n OR＝0.244，95%n CI：0.068～0.871，n P＝0.030)和带蒂骨膜瓣覆盖(n OR＝0.387，95%n CI：0.156～0.962，n P＝0.041)是患者发生CNS感染的独立保护因素。n 结论:对于男性、手术时长>7 h、额窦开放面积≥95.9 mmn 2及引流管放置时间>1 d的神经外科患者，术后发生CNS感染的风险较高，而切开硬膜前封闭额窦和采用带蒂骨膜瓣覆盖额窦可降低术后CNS感染的发生率。n “,”Objective:To investigate the influencing factors of central nervous system (CNS) infection post neurosurgery related to intraoperative opening of frontal sinus.Methods:The clinical data of 159 patients who underwent neurosurgery involving frontal sinus opening at Department of Neurosurgery, the First Hospital of Shanxi Medical University from January 2007 to December 2019 were retrospectively analyzed. Following opening of frontal sinus in all those patients, removal of frontal sinus mucosa was performed in 77 patients, electrocoagulation of frontal sinus inner wall in 35, drilling of frontal sinus inner wall in 7, packing of frontal sinus in 96, sealing of frontal sinus with bone wax in 159, and covering of frontal sinus with pedicled periosteum flap in 95. Based on to the patient's clinical symptoms, cerebrospinal fluid laboratory examination results, blood cell analysis and others, a comprehensive judgment was made regarding whether the patient had the CNS infection. Univariate and multivariate logistic regression analysis were used to determine whether the operative procedure regarding frontal sinus was an independent risk factor of postoperative CNS infection.Results:The median area of intraoperative opening of frontal sinus in 159 patients was 95.9 mmn 2 (11.8-706.6 mmn 2), and operative duration was 6.3±1.9 h. Postoperative CNS infection was diagnosed in 34 cases (21.4%), and no infection occurred in 125 cases (78.6%). The results of univariate analysis showed that gender, dealing with frontal sinus before dural incision, opening area of frontal sinus, duration of operation, drainage tube placement, and number of days of drainage tube placement were influencing factors of postoperative CNS infection (all n P7 h ( n OR=2.935, 95%n CI: 1.143-7.535, n P=0.025), opening area of frontal sinus ≥ 95.9 mmn 2 (n OR=3.767, 95%n CI: 1.418-10.007, n P=0.008), and drainage tube placement length >1 day ( n OR=3.152, 95%n CI: 1.193-8.327, n P=0.021) were independent risk factors for postoperative CNS infection, while closure of frontal sinus before dural incision (n OR=0.244, 95% n CI: 0.068-0.871, n P=0.030) and covering frontal sinus with a pedicled preriosteum flap(n OR=0.387, 95%n CI: 0.156-0.962, n P=0.041) were independent protective factors for postoperative CNS infection.n Conclusions:For male neurosurgical patients with surgical duration of > 7 h, opening area of frontal sinus ≥ 95.9 mm n 2, and drainage tube placement length >1 d, the risk of postoperative CNS infection is higher. In contrast, sealing frontal sinus before dural incision and covering frontal sinus with a pedicled periosteum flap could reduce the incidence of postoperative CNS infection.n