脑膜瘤术后近期预后影响因素分析  

Related factors of early post-operative prognosis of meningiomas： an analysis of 953 surgical cases

作　　者：武宏杰[1] 车彦军[1] 鞠东辉[2] 梁鹏[2] 刘恩重[2] 

机构地区：[1]江苏省靖江市人民医院神经外科,214500 [2]哈尔滨医科大学附属第一医院神经外科

出　　处：《中华医学杂志》2011年第15期1051-1054,共4页National Medical Journal of China

摘　　要：目的 探讨影响脑膜瘤患者术后近期预后的相关因素.方法 回顾性研究哈尔滨医科大学附属第一医院自1999年1月至2006年12月收治的953例良性脑膜瘤患者,用出院时患者的生活质量评分（KPS）来评价预后,对患者的年龄,肿瘤部位,肿瘤大小,术前伴有高血压、糖尿病、心脏病及脑梗死,肿瘤切除级别,术中出血量及合并失血性休克、脑膨出等11个因素行单因素x2检验和多因素Logistic回归模型分析,探讨影响脑膜瘤术后患者近期预后的相关因素.结果 患者年龄、肿瘤部位及大小、术前伴有脑梗死、肿瘤切除级别、术中出血量及合并失血性休克预后差异有统计学意义（P＜0.05）;且肿瘤大小、术前伴有脑梗死、切除级别、术中合并失血性休克是影响预后的独立危险因素.而术前伴有高血压、心脏病、糖尿病及术中合并脑膨出与预后无关（P＞0.05）.结论 患者的年龄、肿瘤的部位和术前合并症都可能影响患者的预后,但肿瘤大小、术前伴有脑梗死、切除级别、术中合并失血性休克是影响预后的独立危险因素.Objective To study the related factors of early post-operative prognosis of meningiomas. Methods The clinical data of 953 patients with meningiomas were recorded and statistically analyzed withx2 test of single factor and logistic regression model of multivariate factors. Patient age; tumor size; tumor location; pre-operative complication of patients such as hypertension, diabetes, heart disease and cerebral infarction; the extent of tumor resection; hemorrhagic shock; blood loss or hemorrhagic shock and brain swelling intra-operatively were taken as variables. The prognosis was evaluated by postoperative Karnofsky performance scale. Results The prognosis was significantly correlated with the patient age, tumor size, tumor location, preoperative cerebral infarction, the extent of tumor resection, blood loss and hemorrhagic shock intra-operatively （ P ＜ 0. 05 ） . Such factors as tumor size, preoperative cerebral infarction, the extent of tumor resection （Simpson＇s scale） and intra-operative hemorrhagic shock were independent risk factors of prognosis for meningiomas. Other factors, such as hypertension, diabetes and heart disease, were unrelated with the prognosis of meningiomas （ P ＞ 0. 05 ）. Conclusion Patient age,tumor location and pre-operative complications of patients maybe affect the early postoperative prognosis of meningiomas. But such factors as tumor size, preoperative cerebral infarction, the extent of tumor resection and intra-operative hemorrhagic shock are independent risk factors for the post-operative prognosis of meningiomas.

关 键 词：脑膜瘤 危险因素 近期预后 

分 类 号：R739.45[医药卫生—肿瘤]