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华西医学  2011 

成人幕上低级别胶质瘤(WHO Ⅱ级)患者术后生活质量相关因素评估

, PP. 674-678

Keywords: 神经胶质瘤,Karnofsky评分,术后,评估

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Abstract:

【】 目的 探讨成人幕上低级别胶质瘤(WHOⅡ级)患者术后生活质量的影响因素。 方法 回顾性分析2008年10月―2010年5月经手术切除病变、术后病理证实为低级别胶质瘤的115例患者临床资料,术后随访6~24个月。以患者年龄、性别、主要临床症状、病变部位、病变大小及病理结果为自变量,以术后Karnofsky评分(KPS)改善为因变量,采用Logistic回归分析研究相关影响因素。采用秩和检验比较不同组间KPS差异。 结果 随访至术后6个月,患者年龄、病变大小、病变部位、切除范围以及是否有癫痫史在KPS比较中,其结果有统计学意义(P0.05)。病理类型、术前是否存在神经功能障碍与术后KPS改善在单因素和多因素比较中无统计学意义。 结论 患者年龄≤50岁、术前有癫痫史、肿瘤直径≤4cm、病变表浅、肿瘤全切除的患者术后KPS改善好于年龄>50岁、术前无癫痫史、肿瘤直径>4cm、病变深在、肿瘤次全切除的患者。患者术前是否存在神经功能障碍和病理类型与术后生活质量是否改善无明显关系。复发也是影响患者术后KPS改善的因素。【Abstract】 Objective Toassessthequalityoflifeinadultswithsurgicallymanagedcerebralsupratentoriallowgradeglioma(WHOgradeⅡ)andtherelevantfactors. Methods Weretrospectivelyanalyzedtheclinicaldataof115patientswithhistologicallyprovensupratentoriallowgradegliomaenrolledatWestChinaHosptialfromOctober2008toMay2010.Follow-uplastedfor6to24monthsafteroperation.Logisitcregressionanalysisisusedtotesttherelevantfactorswithage,gender,mainclinicalmanifestations,lesionlocation,lesionsizeandpathologicalresultsastheindependentvariables,andKamofskypostoperativescale(KPS)scoresasdependentvariable.KPSscoresofdifferentgroupswereanalyzedusingtheranktest. Results After6monthsoffollow-up,wefoundthatage,size,location,extentofsurgicalexcisionandeplispyhistoryshowedastatisticalsignificanceinKPScomparison(P0.05).HistologytypeandneurologicaldeficithadnorelationshipwithKPSimprovementinbothsinglefactoranalysisandmultivariateanalysis. Conclusions Patientswithanageolderthan50years,preoperativeepilepsyhistory,thelargestdiameterofthetumorlessthan4cm,shallowlesions,andcompletetumorresectionhaveabetterKPSimprovementafteroperationthanthosewithcorrespondingoppositeconditions.Thereisnoobviousrelationshipbetweenhistologytype,neurologicdeficitsandKPSimprovementafteroperation.RecurrenceisalsoafactorinfluencingKPSimprovementafteroperation.

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