儿童鼻窦炎相关眶部感染手术决策相关危险因素分析OA

OBJECTIVE To retrospectively analyze the clinical data of pediatric patients with sinonasal-related orbital infections(SROI),identify risk factors associated with surgical decision-making,provide guidance for surgical timing in clinical practice,and establish evidence for rational management of pediatric SROI.METHEDS Medical records of children diagnosed with SROI admitted to Shanxi Children's Hospital from January 1,2011 to December 31,2023 were collected.Patients were divided into surgical and non-surgical groups.Binary logistic regression was used to identify independent risk factors for surgical decision-making in pediatric SROI.RESULTS A total of 150 pediatric patients with SROI were enrolled,of whom 18 underwent surgery.Univariate logistic regression showed that a history of previous SROI(OR=13.00,95%CI:2.01-84.12,P=0.007),postseptal abscess formation(OR=7.45,95%CI:2.61-21.26,P<0.001),proptosis(OR=2.77,95%CI:1.02-7.54,P=0.046),lamina papyracea defect(OR=13.00,95%CI:2.01-84.12,P=0.007),and CRP>76.88 mg/L(OR=9.93,95%CI:1.17~84.04,P=0.035)were risk factors for surgery.Multivariate logistic regression demonstrated that a history of previous SROI(OR=57.53,95%CI:2.55-1 299.91,P=0.011),lamina papyracea defect(OR=22.37,95%CI:1.57-319.84,P=0.022),postseptal abscess(OR=4.79,95%CI:1.36-16.92,P=0.015),CRP>39.50 mg/L(39.50 mg/L<CRP<76.88 mg/L:OR=19.89,95%CI:1.07~369.56,P=0.045;CRP>76.88 mg/L:OR=31.58,95%CI:1.64-606.87,P=0.022)were independent risk factors for surgical intervention.CONCLUSION Surgical decision-making should be considered in pediatric SROI patients with a history of previous SROI,or lamina papyracea defect,or CRP>39.50 mg/L(especially>76.88 mg/L)to avoid delayed treatment.Surgery should be actively performed in patients with radiologically confirmed postseptal abscess who show poor response to anti-infective therapy.