老年脑膜瘤手术治疗（≥65岁）的预后因素与结局

发布时间：2018-02-21 22:51

本文关键词： 脑膜瘤老年人手术结局预后因素　出处：《广西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的探究老年脑膜瘤病人(≥65岁)的手术结局与预后因素。方法回顾性分析86例老年脑膜瘤病人的临床、影像学及随访资料,所有病人年龄均在65岁以上,并于2007年1月至2013年12月在我院神经外科首次诊断为脑膜瘤并接受手术治疗。采用单因素及多因素logistic回归分析明确多项因素(包括年龄、性别、术前神经功能状况、合并症、ASA分级、术前KPS评分、肿瘤部位及大小、瘤周水肿、Simpson切除分级)与预后的关系。结果围手术期死亡率为1.2%,术后并发症率为37.2%。术前已出现神经功能缺损的病人比没有出现神经功能缺损的病人更容易出现术后并发症(P=0.049)。通过单因素分析发现术前出现神经功能缺损、术前KPS≤70及肿瘤位于关键部位与病人出院时低KPS显著相关(分别为p0.001,p0.001和p=0.04)。进一步的多因素logistic回归分析发现只有术前KPS与出院时KPS显著相关(p=0.005)。没有发现任何因素与近期KPS有显著关系。结论当老年脑膜瘤病人的术前KPS70分及尚未出现神经功能缺损时,手术治疗老年脑膜瘤的结局是良好的。但是,当病人术前KPS≤70或者已经出现严重神经功能缺损时,手术治疗应该综合考虑更多的因素,采取个体化治疗。
[Abstract]:Objective to explore the elderly patients with meningioma (over 65 years) of the surgical outcome and prognostic factors. Methods a retrospective analysis of 86 cases of elderly patients with meningioma, imaging and follow-up data, all patients were at least 65 years of age, and from January 2007 to December 2013 in the Department of Neurosurgery of our hospital for diagnosis of meningioma and surgery by logistic. Univariate and multivariate regression analysis to clear a number of factors (including age, gender, functional status, preoperative neurological complications, ASA classification, preoperative KPS score, tumor size and location, peritumoral edema, Simpson resection grade) and prognosis. Results the perioperative mortality rate was 1.2%, postoperative complication rate 37.2%. dicoria neurological impairment than did patients without neurological deficit were more prone to postoperative complications (P=0.049). Through the single factor analysis showed that the preoperative neurological function The defect of preoperative KPS and less than or equal to 70 tumors located in the key parts of the patients was significantly associated with low KPS (respectively p0.001, p0.001 and p=0.04). Multivariate logistic regression analysis showed that only the preoperative KPS and KPS were significantly correlated (p=0.005). No factors have significant relationship with recent KPS conclusion. When the elderly patients with meningioma in the preoperative KPS70 score and neurological deficit has not yet appeared when the outcome of surgical treatment of senile meningioma is good. However, when the patients before the KPS is less than or equal to 70 or have severe neurological defects, surgical treatment should consider more factors, individualized treatment.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R739.45

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