脑功能区病变患者术后早期认知变化的影响因素分析  

The factors on early postperative cognitive status for eloquent areas lesioned patients

作　　者：王丽敏[1] 王伟民[1] 王国良[1] 李天栋[1] 白红民[1] 高寒[1] 

机构地区：[1]广州军区广州总医院神经医学专科医院,广州510010

出　　处：《中华神经外科杂志》2014年第5期454-457,共4页Chinese Journal of Neurosurgery

基　　金：军队临床高新技术重大项目（2010GXJS033）;全军十二五重大项目（AWS12.J004）

摘　　要：目的探讨患者术后早期认知变化的影响因素，为术中认知功能保护奠定基础。方法选取96例功能区病变的患者，采用中国韦氏成人智力量表修订版（WAIS—RC）简版对患者手术前后智力情况进行评估，对术后认知下降有影响的性别、年龄、文化程度、病变侧、病变部位、病变大小、病理改变、病灶对功能区的侵袭程度、及手术切除程度进行单因素及多因素非条件logistic回归分析，分析术后认知下降的危险因素。结果术后VIQ、PIQ、FIQ与术前相比差异统计学意义（χ2=19．81，P〈0．01），其中病变侧为优势侧、病变侵袭程度高、且手术切除程度高是患者早期术后认知功能下降的危险因素。结论术中清晰定位功能区边界，沿边界最大限度地切除病灶，能最大限度地保护患者的术后早期认知功能。Objective To discuss and what on early postoperative cognitive change of brain eloquent areas lesioned patients to provide a basis to protect patient cognitive function in surgery . Methods 96 eloquent areas lesioned patjents were selected and accepted pre-postoperative intelligence assessing by Chinese modified ＂ Wechsler Adult Intelligence Scale＂. Using single factor and multi-factor unconditioned logistic regression to what on postoperation IQ deciline from gender, age, education, lesion side, site, size, pathological change, degree of lesioned invasion function, and the degree of resection by SPSS 15. 0. Results The significant differences exsited between the post-preoperative VIQ, PIQ, FIQ（ χ2 = 19. 81, P 〈 0. 01 ）, dominant hemisphere lesioned, degree of invasion and degree of were dangerous factors of the early postoperative IQ decline. Conclusion In order to protect postoperative early function of patients, it＇s very important to make intraoperative function boundary mapping clearly and brain lesions along the border as much as possible.

关 键 词：脑功能区病变 术后早期认知功能 个体因素 病变因素 手术因素 

分 类 号：R739.41[医药卫生—肿瘤]