功能区上矢状窦旁脑膜瘤术后暂时性瘫痪危险因素分析  

Risk factors for postoperative provisional paralysis of parasagittal meningioma in the eloquent area

作　　者：徐德才[1] 李健[1] 赵永轩[1] 马骏[1] 刘后银[1] 苏贺先[1] 

机构地区：[1]蚌埠医学院第一附属医院神经外科,蚌埠233004

出　　处：《中国神经精神疾病杂志》2016年第8期465-468,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的探讨功能区上矢状窦旁脑膜瘤术后暂时性瘫痪的危险因素。方法回顾性分析2005年5月至2015年12月手术治疗的96例功能区上矢状窦旁脑膜瘤患者临床资料，根据暂时性瘫痪诊断标准，分为暂时性瘫痪组（n=31）和非暂时性瘫痪组（n=65），采用单因素分析和Logistic回归分析两组患者年龄、肿瘤大小、术前瘤周水肿、术前癫痫、上矢状窦完全被肿瘤侵犯闭塞、术中切开窦壁、术中回流静脉损伤等因素。结果单因素分析显示两组间年龄（r=14．943，P=0．000）、术前瘤周水肿（r=4．435，P=0．049）、上矢状窦完全被肿瘤侵犯闭塞（r=5．248，P=0．028）、术中切开窦壁（r=5．773，P=0．026）以及术中回流静脉损伤（x2=11．441，P=0．002）比较差异有统计学意义；Logistic回归分析上述因素显示年龄（OR=8．709，P=0．028）、术中回流静脉损伤（0R=16．242，P=0．012）、上矢状窦完全被肿瘤侵犯闭塞（OR=0．053，P=0．025）为术后暂时性瘫痪发生的相关因素。结论年龄和术中回流静脉损伤是术后暂时性瘫痪发生的危险因素，而上矢状窦完全被肿瘤侵犯闭塞是其保护因素。Objective The aim of the study was to investigate the related factor of postoperative provisional paraly- sis of parasagittal meningioma in the eloquent area. Methods A retrospective review was conducted on ninety-six pa- tients with parasagittal meningioma in the eloquent area treated by surgery from May 2005 to December 2015. Accord- ing to the diagnostic criteria for postoperative provisional paralysis, patients were divided into postoperative provisional paralysis group （n=31 ）and non- postoperative provisional paralysis group （n=65）. Univariate and multivariate logistic regression methods were used to analyze the data including age, size of tumor,preoperative epilepsy, preoperative periph- eral edema, complete the occlusion of superior sagittal sinus （SSS） by tumor, incision of SSS during surgery, drainage vein damage during surgery. Results Univariate analysis showed that there were significant differences （P〈0.05）between these two groups in age （X2=14.943, P=0.000）, preoperative peripheral edema（X2=4.435, P=0.049）, the complete occlu- sion of SSS by tumor （X2=5.248, P=0.028）, incision of SSS during surgery （x2=5.773, P=0.026）, drainage vein damage during surgery （X2=11.441, P=0.002）. Multivariate analysis showed that the factors related to postoperative provisional paralysis were age （OR=8.709,P=0.028）, drainage vein damage during surgery （OR=16.242,P=0.012） and complete oc- clusion of SSS by tumor（ OR=0.053,P=0.025 ）. Conclusion Age and the drainage vein damage during surgery are the risk factors of postoperative provisional paralysis and complete occlusion of SSS by tumor is the protective factor for the oe-currence of postoperative provisional paralysis.

关 键 词：功能区上矢状窦 脑膜瘤 瘫痪 危险因素 

分 类 号：R739.45[医药卫生—肿瘤]