[1]汪方正　陈卫民　鲁艾琳　陆小明.高颈段椎管内肿瘤预后影响因素分析[J].中国临床神经外科杂志,2017,(01):26-27,30.[doi:10.13798/j.issn.1009-153X.2017.01.009]
　WANG Fang-zheng,CHEN Wei-min,LU Ai-lin,et al.Risk factors related to prognoses in patients with superior cervical spinal tumors[J].,2017,(01):26-27,30.[doi:10.13798/j.issn.1009-153X.2017.01.009]
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高颈段椎管内肿瘤预后影响因素分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年01期
页码:
26-27,30
栏目:
论著
出版日期:
2017-01-18

文章信息/Info

Title:
Risk factors related to prognoses in patients with superior cervical spinal tumors
文章编号:
1009-153X（2017）01-0026-02
作者:
汪方正　陈卫民　鲁艾琳　陆小明
223900 江苏，泗洪县人民医院神经外科（汪方正、陈卫民）；210029 南京，江苏省人民医院神经外科（鲁艾琳、陆小明）
Author(s):
WANG Fang-zheng1;  CHEN Wei-min1;  LU Ai-lin2;  LU Xiao-ming1.
1. Department of Neurosurgery, People’s Hospital of Sihong County, Suqian 223900, China; 2. Department of Neurosurgery, People’s Hospital of Jiangsu Province, Nanjing 210029, China
关键词:
高颈段椎管内肿瘤; 显微手术; 预后; 危险因素; 多元Logistic回归分析
Keywords:
Superior cervical spinal tumor;  Microneurosurgery;  Risk Factors;  Logistic multiple regression analysis;  Prognosis
分类号:
R 739.42; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.01.009
文献标志码:
A
摘要:
目的 探讨影响高颈段椎管内肿瘤预后的相关因素。方法 回顾性分析手术治疗的138例高颈段椎管内肿瘤的临床资料，采用多因素Logistic回归分析检验相关影响因素。结果 138例中，预后不良26例（18.8%），预后良好112例（81.2%）。多因素Logistic回归分析显示，肿瘤次全切除（OR=6.982，P=0.027）、肿瘤为恶性（OR=5.769，P=0.008）、肿瘤直径≥4 cm（OR=5.547，P=0.043）、全椎板手术（OR=5.321，P=0.039）、肿瘤位于髓内（OR=4.854，P=0.037）、肿瘤段位较高（OR=4.586，P=0.036）、术前肌力≤3级（OR=3.395，P=0.041）、年龄≥60岁（OR=2.258，P=0.012）为患者预后不良的危险因素，而术中神经电生理监测（OR=0.426，P=0.026）、术后使用激素（OR=0.492，P=0.035）为预后良好的保护因素。结论 影响高颈段椎管内肿瘤预后的因素较多，临床上可根据患者具体情况制定合理科学防范措施以提高治疗效果。
Abstract:
Objective To analyze the risk factors related to prognoses in the patients with superior cervical spinal tumors. Methods The clinical data of 138 patients with superior cervical spinal tumors treated by microneurosurgery in our hospital were analyzed retrospectively. The risk factors related to the prognoses in those patients were analyzed with multivariate logistic regression analysis. Results Of 138 patients, 112 (81.2%) were recovered well and 26 (18.8%) badly. The result of single factor analysis showed that the prognosis was statistically related to age, tumor size, tumor locations, tumor nature, operative methods, whether the tumors were totally resected, preoperative muscle strength, whether electrophysiological monitoring was intraoperatively performed, and whether hormone was postoperatively used in the patients (P<0.05). Multivariate logistic regression showed that the risk factors related to prognosis included the incomplete resection of tumor (OR=6.982), malignance (OR=5.769), more than or equal to 4 cm tumor diameter (OR=5.547), resection of complete vertebral plate (OR=5.321), intramedullar tumor (OR=4.854), more superior cervical spinal tumor (OR=4.586), less than or equal to grade 3 preoperative muscle strength (OR=3.395) and more than or equal to 60 years old (OR=2.258) in these patients. The protective factors of prognosis included intraoperative electrophysiological monitoring (OR=0.426) and postoperative use of hormone (OR=0.492). Conclusions There are many risk factors related to the prognoses in the patients with superior cervical spinal tumor, in whom according to the specific situations of the patients, rational and scientific prevention measures should be taken to improve the prognosis.

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更新日期/Last Update: 2016-10-28