经胼胝体-穹窿间入路的颅咽管瘤儿童认知功能受损相关危险因素分析  

The analysis on related risk factors of impaired cognitive function in craniopharyngioma children by transcallosal-interforniceal approach surgery

作　　者：李健[1] 郑利敏[1] 

机构地区：[1]山东泰安市中心医院神经外科,泰安271000

出　　处：《立体定向和功能性神经外科杂志》2015年第5期279-283,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：泰安市科技局科技发展规划项目(编号:2015NS2133)

摘　　要：目的经胼胝体-穹窿间入路的颅咽管瘤儿童认知功能受损的表现与相关危险因素。方法分析2007年1月-2014年6月我院51例经胼胝体穹窿间入路的颅咽管瘤儿童患儿的临床资料,将22例术后出现认知障碍的患儿纳为观察组,将未出现认知障碍的患儿归为对照组。结果观察组患者常识（t=7.134,P〈0.001）、算术（t=4.859,P〈0.001）、词汇（t=9.176,P〈0.001）、领悟（t=3.269,P=0.002）、数字广度（t=4.941,P〈0.001）、言语智商（t=7.917,P〈0.001）、总智商评分（t=5.895,P〈0.001）明显低于对照组,差异具有统计学意义（P〈0.05）;两组研究对象在年龄（χ^2=4.961,P=0.026）、肿瘤大小（χ^2=4.796,P=0.029）、切除程度（χ^2=4.638,P=0.031）、术后是否放疗水平（χ^2=2.774,P=0.006）比较上差异具有统计学差异（P〈0.05）。而在是否存在囊性、钙化水平上无统计学差异（P〉0.05）;运用Logistic多因素逐步回归分析方法分析经胼胝体穹窿间入路的颅咽管瘤儿童相关因素与认知功能障碍的关系,其中以认知功能障碍为因变量,以年龄、肿瘤大小、是否囊性、是否钙化、切除程度、术后是否放疗因素为自变量,发现年龄、肿瘤大小、切除程度、术后是否放疗是经胼胝体穹窿间入路的颅咽管瘤儿童认知功能受损的独立危险因素。结论采用经胼胝体-穹窿间入路手术可导致颅咽管瘤患儿出现语言及记忆功能的缺失,其中年龄、肿瘤大小、切除程度、术后否放疗是经胼胝体穹窿间入路的颅咽管瘤儿童,是认知功能障碍的独立危险因素。Objective To investigate theAnalysis on related risk factors of impaired cognitive function in craniopharyngioma children by transcallosal-interforniceal approach surgery.Methods Analyzing the clinical data of 51 cases with transcallosal-interforniceal approach surgery of craniopharyngioma in our hospital from January 2007 to June 2014,The children of 22 patients with postoperative cognitive dysfunction were selected as observation group,the children who will not present cognitive impairment children were selected as control group.Results common sense（t=7.134,P〈0.001）,arithmetic（t=4.859,P〈0.001）,vocabulary（t=9.176,P〈0.001）,and understanding（t=3.269,P=0.002）,and digit span（t=4.941,P〈0.001）,verbal IQ（t=7.917,P 0.001）,total IQ score（t=5.895,P〈0.001）in observation group patients were significantly lower than the control group,the difference have statistically significant（P 0.05）;the comparisons of age（chi-square=4.961,P=4.961）and tumor size（chi-square=4.796,P=4.796）,the degree of resection（chi-square=4.638,P=4.638）,postoperative radiotherapy level（chi-square=2.774,P=2.774）,the difference in two groups were statistically difference（P〈0.05）.Whether in capsule,the calcium level had no statistical difference（P〉0.05）;By Logistic multi-factor stepwise regression analysis method on analyzing the relationship between related factors and cognitive dysfunction with transcallosal-interforniceal approach surgery of craniopharyngioma children the cognitive dysfunction as dependent variable,age,tumor size,cystic or not,calcification or not,extent of resection,postoperative radiotherapy factors as independent variables,it found that age,tumor size,degree of resection,postoperative radiotherapy is independent risk factors for craniopharyngioma children with impaired cognitive function by transcallosal-interforniceal approach surgery.Conclusion Adopted by transcallosal-interforniceal approach surgery can cause craniopharyngioma children to appear the lack of langua

关 键 词：颅咽管瘤 认知功能 胼胝体 入路 

分 类 号：R739.41[医药卫生—肿瘤]