高龄脊膜瘤患者的手术疗效分析  

Analysis of surgical outcomes of elderly patients with meningiomas

作　　者：金铂[1] 陈燕超 黄志高 张苏欣 苏亦兵[1] Jin Bo;Chen Yanchao;Huang Zhigao;Zhang Suxin;Su Yibing(Department of Neurosurgery,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院神经外科,北京100035

出　　处：《中华神经外科杂志》2023年第3期244-248,共5页Chinese Journal of Neurosurgery

基　　金：北京积水潭医院自然基金培育计划(ZR-202107)。

摘　　要：目的探讨高龄脊膜瘤患者的手术疗效。方法回顾性分析2015年1月至2020年12月北京积水潭医院神经外科手术治疗的101例脊膜瘤患者的临床资料。采用McCormick分级评价患者术前、术后7 d以及术后3个月的脊髓神经功能。采用Simpson分级评估肿瘤切除程度。采用术前与术后McCormick分级的差值评价患者术后脊髓神经功能的改善程度。根据年龄进行分组,年龄≥70岁为高龄组(23例),<70岁为对照组(78例)。比较两组患者的基线资料、手术疗效及并发症。结果两组患者比较,性别、术前临床症状、症状持续时间、肿瘤所在节段、肿瘤所在位置、肿瘤最大径、肿瘤钙化情况、术前McCormick分级的差异均无统计学意义(均P>0.05)。与对照组比较,高龄组美国麻醉医师协会分级高、合并症种类多(均P<0.05)。与术前比较,高龄组和对照组患者术后7 d、3个月的McCormick分级均呈下降趋势(Z值分别为35.52、125.10,均P<0.001)。两组患者肿瘤切除程度Simpson分级、术后7 d和3个月的McCormick分级、术后脊髓神经功能改善程度的差异均无统计学意义(均P>0.05)。并发症方面,高龄组与对照组患者比较,脑脊液漏[分别为4.3%(1/23)、1.3%(1/78)]、切口出血[分别为0、1.3%(1/78)]、切口感染[分别为0、1.3%(1/78)]发生率的差异均无统计学意义(均P>0.05)。结论高龄脊膜瘤患者接受手术治疗安全、有效,可改善脊髓神经功能。Objective To investigate the surgical outcomes of elderly patients with meningiomas.Methods The clinical data of 101 patients with meningiomas treated by neurosurgery at the Department of Neurosurgery,Beijing Jishuitan Hospital from January 2015 to December 2020 were retrospectively analyzed.McCormick grade was used to evaluate the spinal cord function of patients before operation,7 days and 3 months after operation.The degree of tumor resection was evaluated by Simpson grading system.The difference between preoperative and postoperative McCormick grades was used to evaluate the improvement of spinal cord function of patients after surgery.According to the age,the elderly group(23 cases)was aged≥70 years old,and the control group(78 cases)was aged<70 years old.The baseline data,surgical efficacy and complications of the two groups were compared.Results There was no statistically significant difference between the two groups in the gender,preoperative clinical symptoms,duration of symptoms,tumor segment,tumor location,maximum tumor diameter,tumor calcification,or preoperative McCormick grade(all P>0.05).Compared with the control group,the elderly group had higher ASA(American Society of Anesthesiologists)grade and more types of complications(both P<0.05).Compared with pre-operation,the McCormick grading of patients in the elderly group and the control group showed a downward trend at 7 days and 3 months after operation(Z value:35.52 and 125.10 respectively,both P<0.001).There was no significant difference between the two groups in the degree of tumor resection(Simpson grade),the McCormick grade 7 days and 3 months after surgery,and the degree of improvement of spinal cord function after surgery(all P>0.05).In terms of complications,there was no significant difference in the incidence of cerebrospinal fluid leakage[4.3%(1/23)vs.1.3%(1/78)],incision bleeding[0 vs.1.3%(1/78)]and incision infection[0 vs.1.3%(1/78)]between the elderly group and control group(all P>0.05).Conclusion Surgical treatment for elderly patie

关 键 词：脑膜肿瘤 脊髓损伤 神经外科手术 治疗结果 高龄 

分 类 号：R739.45[医药卫生—肿瘤]