清醒麻醉下切除脑胶质瘤时术中癫痫的危险因素  

Analysis of risk factors for intraoperative epilepsy during glioma resection under awake anesthesia

作　　者：邹鹏 刘剑 张昊阜子 杨二万 田志成 罗鹏 蒋晓帆 ZOU Peng;LIU Jian;ZHANG Haofuzi;YANG Erwan;TIAN Zhicheng;LUO Peng;JIANG Xiaofan(Xijing Hospital Affiliated to Air Force Military Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学附属西京医院,陕西西安710032

出　　处：《中国实用神经疾病杂志》2022年第11期1342-1347,共6页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金资助面上项目(编号:82171458)。

摘　　要：目的探讨清醒麻醉下切除脑功能区胶质瘤时术中癫痫的危险因素。方法回顾性分析2020-09—2022-09在西京医院神经外科收治的183例脑功能区胶质瘤病例,根据术中有无癫痫可分为术中癫痫组36例和术中无癫痫组147例,并对2组进行Logistic危险因素分析。结果Logistic回归分析显示肿瘤在中央前回、术前有癫痫、术前MMSE评分低和术中刺激电流>3 mA为术中癫痫发作的独立危险因素(OR=2.521、2.893、3.867、2.671,均P<0.05),ROC曲线结果显示术前MMSE评分<24分对术中癫痫有预测价值。结论肿瘤在中央前回、术前有癫痫、术前MMSE<24分和术中刺激电流>3 mA为术中癫痫的独立危险因素,针对危险因素提前采取精准防治,对改善患者预后意义重大。Objective To investigate the risk factors of intraoperative epilepsy during the resection of glio⁃mas in functional areas under awake anesthesia.Methods From September 2020 to September 2022,183 cases of glioma in the brain functional area admitted to Neurosurgery Department of Xijing Hospital were retrospectively analyzed.According to the intraoperative epilepsy,they were divided into epilepsy group 36 cases and non-epilep⁃sy group 147 cases.Logistic risk factors were analyzed for the two groups.Results Logistic regression analysis showed that tumor in the precentral gyrus,preoperative epilepsy,low preoperative MMSE score and intraoperative stimulation current>3 mA were independent risk factors for intraoperative seizures(OR=2.521,2.893,3.867,2.671,allP<0.05).The results of ROC curve showed that preoperative MMSE score<24 had predictive value for intraoperative epilepsy.Conclusion Precentral gyrus,preoperative epilepsy,preoperative MMSE<24 and intraope-rative stimulation current>3 mA are independent risk factors for intraoperative epilepsy.Precise prevention and treatment of risk factors in advance is of great significance to improve the prognosis of patients.

关 键 词：术中癫痫 清醒麻醉 脑胶质瘤 危险因素 

分 类 号：R730.264[医药卫生—肿瘤]