脑肿瘤患者围手术期认知功能障碍的临床研究  

The clinical research of perioperative neurocognitive dysfunction in brain tumor patients

作　　者：张红波[1] 穆林森[2] 孙彦辉[1] 李杰飞[3] 李梦凯[1] 黄博渊 申辉[1] 郭世超[1] 袁飞[1] 

机构地区：[1]首都医科大学北京市神经外科研究所,100050 [2]广州市脑科医院神经外科 [3]清华大学玉泉医院神经外科

出　　处：《中华神经外科杂志》2015年第3期225-227,共3页Chinese Journal of Neurosurgery

摘　　要：目的 探讨脑肿瘤患者围手术期认知功能障碍的临床特点.方法 采用蒙特利尔认知量表对140例脑肿瘤患者进行手术前后认知功能评估.分析比较手术前后不同部位和不同病理类型认知功能状况及临床特征.结果 140例脑肿瘤患者中术前认知障碍病例数及患病率为83例（59.2％）,评分（24.1±2.4）分.术后认知障碍病例数及患病率为113例（80.7％）,评分（20.5±4.1）分.术后认知评分较术前明显降低（P＜0.05）.恶性组与幕上脑肿瘤组术后认知障碍患病率分别明显高于术前（80.0％∶98.3％,71.8％：92.2％,均P＜0.05）.结论 脑肿瘤患者术前即存在着不同程度的认知功能障碍,恶性及幕上脑肿瘤者术后早期认知功能障碍较术前加重.Objective To study the clinical characteristics of the perioperative cognitive dysfunction in brain tumor patients.Methods One hundred and forty cases of brain tumor patients were evaluated by using the Chinese vesion of Montreal Cognitive Assessment Questionnaire before and after surgery.The distribution and clinical features of cognitive dysfunction in different located lesions and pathological types were analyzed and compared.Results Among the 140 brain tumor patients,the preoperative cognitive impairment and prevalence rate were 59.2%,the score was 24.2 ± 2.4.The postoperative cognitive impairment and prevalence rate were 80.7%,the score was 20.5 ± 4.1.The postoperative cognitive dysfunction prevalence was significantly higher than the preoperative in benign and malignant with infra or supratentorial brain tumor patients（80.0% vs 98.3%,71.8% vs 92.2%,all P 〈0.05）.Conclusions Vary different extent cognitive impairment was found in brain tumor patients in preoperative period.The postoperative cognitive dysfunction was seriously worse than that in the preoperative period in malignant and supratentorial brain tumors in earlier recovery period.

关 键 词：脑肿瘤 认知障碍 围手术期 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R739.41[医药卫生—临床医学]