额叶胶质瘤扩大切除对认知的影响  

The effect of extended resection of frontal lobe glioma on cognition

作　　者：章炜[1,2] 蔡旭[1] 谢坚[1] 侯宗刚[1] 郝淑煜[1] 李健[1] 于兰冰[1] 

机构地区：[1]首都医科大学附属北京天坛医院神经外科国家神经系统疾病临床研究中心,100050 [2]中国航天科工集团七三一医院神经外科

出　　处：《北京医学》2017年第5期496-498,共3页Beijing Medical Journal

基　　金：北京市科委首都市民健康项目培育(Z131100006813011);首都医科大学基础-临床合作基金(13JL04)

摘　　要：目的从认知功能的角度探讨额叶胶质瘤扩大切除手术的可行性及安全性。方法回顾性分析北京天坛医院神经外科自2014年9月至2015年12月间收治的66例额叶胶质瘤患者的临床资料。所有患者均由同一术者完成肿瘤扩大切除。依据胼胝体是否受到侵犯将患者分为2组,分别采用蒙特利尔认知评估量表对患者术前、术后7d及术后14d的认知状况进行评估。结果 66例患者的术前、术后7 d、14 d的蒙特利尔认知评分分别为25.88±2.33、22.06±2.27、25.35±2.32分,手术前后不同时间蒙特利尔认知评分的差异有统计学意义(F=71.793,P=0.000)。在未侵犯胼胝体组和侵犯胼胝体组,同组手术前后不同时间蒙特利尔认知评分的差异均有统计学意义(P均<0.05);同组术前和术后7 d、术后7 d和术后14 d的蒙特利尔认知评分的差异有统计学意义(P=0.000),术前和术后14 d评分差异则无统计学意义(侵犯胼胝体组P=0.066,未侵犯胼胝体组P=0.653)。结论额叶胶质瘤患者在接受肿瘤扩大切除术后,认知功能会有一定程度的下降。但是,经过一段时间的恢复,可以达到术前水平。从认知功能的角度考虑,额叶胶质瘤扩大切除手术是安全、可行的。Objective To explore the feasibility and safety of extending the resection of frontal lobe glioma from the perspective of cognitive function. Methods A retrospective analysis was carried out on 66 patients with frontal gliomas treated in Department of Neurosurgery, Beijing Tiantan Hospital from September 2014 to December 2015. All the patients underwent the extended resection of tumor by the same surgeon. On the basis of whether the tumor invaded the corpus callosum, the patients were divided into 2 groups, and the Montreal cognitive assessment scales were used to evaluate the cognitive status of the patients at the 7th day before the operation and the 7th,14th day after the operation respectively, using variance analysis of repeated measurement quantitative data for the statistical analysis of the results. Results Whether the tumor invaded the corpus callosum or not, the cognitive function of patients were significantly worse than the preoperative level within 7 days after surgery （P=0.000）, and the patients recovered to the preoperative level basically on the 14th day after surgery（the group with invasion of the corpus callosum： P=0.066, the group without invasion of the corpus callosum： P=0.653）. Conclusion The cognitive function of patients with frontal lobe glioma may have a certain degree of decline after the tumor resection. However, after a period of recovery, the cognitive function can reach the preoperative level. From the perspective of cognitive function, it is safe and feasible to expand resection of frontal lobe glioma.

关 键 词：额叶 认知功能 胶质瘤 肿瘤扩大切除术 

分 类 号：R739.41[医药卫生—肿瘤]