[1]郭正乾　陈　勇　曹　丹　陈　旭　陈　坚.老年脑膜瘤术后发生并发症的危险因素分析[J].中国临床神经外科杂志,2021,26(04):258-260.[doi:10.13798/j.issn.1009-153X.2021.04.011]
　GUO Zheng-qian,CHEN Yong,CAO Dan,et al.Risk factors related to postoperative complications in elderly patients with meningioma[J].,2021,26(04):258-260.[doi:10.13798/j.issn.1009-153X.2021.04.011]
点击复制

老年脑膜瘤术后发生并发症的危险因素分析()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年04期
页码:
258-260
栏目:
论著
出版日期:
2021-04-25

文章信息/Info

Title:
Risk factors related to postoperative complications in elderly patients with meningioma
文章编号:
1009-153X（2021）04-0258-03
作者:
郭正乾　陈　勇　曹　丹　陈　旭　陈　坚
430030 武汉，华中科技大学同济医学院附属同济医院神经外科（郭正乾、陈　勇、曹　丹、陈　旭、陈　坚）
Author(s):
GUO Zheng-qian;  CHEN Yong;  CAO Dan;  CHEN Xu;  CHEN Jian.
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
关键词:
脑膜瘤; 老年人; 术后并发症; 危险因素
Keywords:
Meningioma;  Elderly patient;  Postoperative complication;  Risk factor
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2021.04.011
文献标志码:
A
摘要:
目的 探讨老年（年龄≥65岁）脑膜瘤术后发生并发症的危险因素。方法 回顾性分析2014年1月至2019年12月手术治疗的227例老年脑膜瘤的临床资料。术后并发症是指导致住院时间延长、术后神经功能缺失或需行各项临床操作甚至二次手术的异常情况，分为神经系统并发症（如颅内出血、癫痫、脑脊液漏、颅内感染、新发神经功能障碍、精神症状等）和全身并发症（如切口愈合不良、肺部感染、心功能异常、肝肾功能损害、消化道出血、深静脉血栓等）。结果 227例中，术后56例（24.67%）有并发症，其中神经系统并发症39例，全身并发症21例。多因素logistic回归分析显示，术前KPS评分<80分、肿瘤最大直径≥6 cm、肿瘤未全切除是术后发生神经系统并发症的独立危险因素（P<0.05）；美国麻醉医师协会（ASA）分级Ⅲ~Ⅳ级、术前血清白蛋白<35 g/L、术中异体输血是术后发生全身并发症的独立危险因素（P<0.05）。结论 老年脑膜瘤术后并发症发生率较高。肿瘤大小及切除程度与术后神经系统并发症有关，而术前身体状况（例如ASA分级、KPS评分、血清白蛋白）、术中输血与术后全身并发症相关。
Abstract:
Objective To explore the risk factors of postoperative complications in the elderly patients (≥65 years old) with meningioma. Methods The clinical data of 227 elderly patients with meningioma who underwent microsurgery from January 2014 to December 2019 were analzyed retropsectively. The postoperative complications were defined as the abnormal conditions resulting in prolonged hospital stay, postoperative neurological deficits, need for various clinical operations or even secondary operations, which were divided into the neurological complications (such as intracranial hemorrhage, epilepsy, cerebrospinal fluid leakage, intracranial infections, new neurological dysfunction, mental symptoms, etc.) and systemic complications (such as poor incision healing, lung infection, abnormal heart function, liver and kidney damage, gastrointestinal bleeding, deep vein thrombosis, etc.). Results Of these 227 patients, the postoperative complications occurred in 56 (24.67%) patients, including 39 neurological complications and 21 systemic complications. Multivariate logistic regression analysis showed that preoperative KPS score <80 points, maximum tumor diameter ≥6 cm, and incomplete tumor resection were independent risk factors for the postoperative neurological complications (P<0.05); American Association of Anesthesiologists (ASA ) grade Ⅲ~Ⅳ, preoperative serum albumin<35 g/L, and intraoperative allogeneic blood transfusion were independent risk factors for the postoperative systemic complications (P<0.05). Conclusions The incidence of postoperative complications is high in the elderly patients with meningiomas. Tumor size and extent of tumor resection are related to postoperative neurological complications, while preoperative physical conditions (such as ASA grade, KPS score, serum albumin) and intraoperative blood transfusion are related to postoperative systemic complications.

参考文献/References:

[1] Bateman BT, Pile-Spellman J, Gutin PH, et al. Meningioma resection in the elderly: nationwide inpatient sample, 1998~2002 [J]. Neurosurgery, 2005, 57(5): 866-872.
[2] Isobe N, Ikawa F, Tominaga A, et al. Factors related to frail-ty associated with clinical deterioration after meningioma surgery in the elderly [J]. World Neurosurg, 2018, 119: e167-e173.
[3] Zhao X, Zhao D, Wu Y, et al. Meningioma in the elderly: Characteristics, prognostic factors, and surgical strategy [J]. J Clin Neurosci, 2018, 56: 143-149.
[4] Guo S, Gerganov V, Giordano M, et al. Elderly patients with frontobasal and suprasellar meningiomas: safety and efficacyof tumor removal via frontolateral approach [J]. World Neu-rosurg, 2020, 135: e452-e458.
[5] Kolakshyapati M, Ikawa F, Abiko M, et al. Multivariate risk factor analysis and literature review of postoperative dete-rioration in Karnofsky Performance Scale score in elderly patients with skull base meningioma [J]. Neurosurg Focus, 2018, 44(4): E14.
[6] Goldbrunner R, Minniti G, Preusser M, et al. EANO guide-lines for the diagnosis and treatment of meningiomas [J]. The Lancet Oncology, 2016, 17(9): e383-e391.
[7] Sacko O, Sesay M, Roux FE, et al. Intracranial meningioma surgery in the ninth decade of life [J]. Neurosurgery, 2007, 61(5): 950-954.
[8] 陈维涛，倪红斌，梁维邦，等. 大型脑膜瘤术后术区出血原因探讨及处理体会[J]. 中华临床医师杂志（电子版），2011，5（15）：4570-4572.
[9] Meling TR, Da Broi M, Scheie D, et al. Skull base versus non-skull base meningioma surgery in the elderly [J]. Neu-rosurg Rev, 2019, 42(4): 961-972.
[10] Patil H, Garg N, Navakar D, et al. Clinical experience of autologous blood transfusion in neurosurgery: prospective study in central India [J]. World Neurosurg, 2018, 115: e539-e543.
[11] Tai YH, Wu HL, Mandell MS, et al. The association of allogeneic blood transfusion and the recurrence of hepatic cancer after surgical resection [J]. Anaesthesia, 2020, 75(4): 464-471.

相似文献/References:

[1]李春坡　郑　军　李海元　边　涛　韩安国.侧脑室三角区小型脑膜瘤的显微外科治疗[J].中国临床神经外科杂志,2015,(11):694.[doi:10.13798/j.issn.1009-153X.2015.11.018]
[2]王林风　郑华山　操　廉.中央沟区矢状窦旁脑膜瘤的显微手术治疗（附25例报告）[J].中国临床神经外科杂志,2016,(07):431.[doi:10.13798/j.issn.1009-153X.2016.07.014]
[3]邓学云　刘　毅　范润金　刘丽华　夏祥国.E-cadherin与脑膜瘤分级及瘤周水肿的关系[J].中国临床神经外科杂志,2016,(04):213.[doi:10.13798/j.issn.1009-153X.2016.04.007]
　DENG Xue-yun,LIU Yi,FAN Run-jin,et al.Relationship of E-cadherin with the pathological grade of meningioma and peritumoral brain edema in patients with meningioma[J].,2016,(04):213.[doi:10.13798/j.issn.1009-153X.2016.04.007]
[4]马　磊　张海红　郭　康　孙树凯　张　亮　贾　栋.神经导航辅助下手术治疗侧脑室脑膜瘤1例[J].中国临床神经外科杂志,2016,(04):255.[doi:10.13798/j.issn.1009-153X.2016.04.023]
[5]王　一　崔焕喜　林令超　孙思辉　李绍山　周庆九　刘　波　柳　琛.侧脑室三角区脑膜瘤的显微手术治疗[J].中国临床神经外科杂志,2016,(03):161.[doi:10.13798/j.issn.1009-153X.2016.03.010]
　WANG Yi,CUI Huan-xi,LIN Ling-chao,et al.Microsurgery for meningiomas in the trigones of lateral ventricles (report of 47 cases)[J].,2016,(04):161.[doi:10.13798/j.issn.1009-153X.2016.03.010]
[6]皮水平　刘　杰　黄前樟.长期服用抗凝药物的老年颅脑损伤患者治疗体会[J].中国临床神经外科杂志,2016,(02):117.[doi:10.13798/j.issn.1009-153X.2016.02.022]
[7]王　鹏 综述　王　勇 审校.岩斜区脑膜瘤的手术入路[J].中国临床神经外科杂志,2016,(02):120.[doi:10.13798/j.issn.1009-153X.2016.02.024]
[8]漆松涛　刘　忆.关于WHO2007年版脑膜瘤病理分类一些问题的商榷[J].中国临床神经外科杂志,2016,(02):125.[doi:10.13798/j.issn.1009-153X.2016.02.026]
[9]李登辉　程　荆　李志强.镰旁脑膜瘤术后并发格林巴利综合征1例[J].中国临床神经外科杂志,2016,(02):72.[doi:10.13798/j.issn.1009-153X.2016.02.003]
[10]肖宗宇　陈晓娟　裴　杰　贺瑛福　许常林　马进海.超声吸引器在脑膜瘤手术切除中的应用[J].中国临床神经外科杂志,2015,(10):626.[doi:10.13798/j.issn.1009-153X.2015.10.016]

备注/Memo

备注/Memo:
通讯作者：陈　坚，E-mail：husttjchen110@163.com
更新日期/Last Update: 2021-04-25