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目的探讨成人幕上低级别胶质瘤(WHOⅡ级)患者术后生活质量的影响因素。方法回顾性分析2008年10月—2010年5月经手术切除病变、术后病理证实为低级别胶质瘤的115例患者临床资料,术后随访6～24个月。以患者年龄、性别、主要临床症状、病变部位、病变大小及病理结果为自变量,以术后Karnofsky评分(KPS)改善为因变量,采用Logistic回归分析研究相关影响因素。采用秩和检验比较不同组间KPS差异。结果随访至术后6个月,患者年龄、病变大小、病变部位、切除范围以及是否有癫痫史在KPS比较中,其结果有统计学意义(P<0.05)。随访至术后12个月,切除范围和癫痫史对KPS评分已无影响(P>0.05)。病理类型、术前是否存在神经功能障碍与术后KPS改善在单因素和多因素比较中无统计学意义。结论患者年龄≤50岁、术前有癫痫史、肿瘤直径≤4cm、病变表浅、肿瘤全切除的患者术后KPS改善好于年龄>50岁、术前无癫痫史、肿瘤直径>4cm、病变深在、肿瘤次全切除的患者。患者术前是否存在神经功能障碍和病理类型与术后生活质量是否改善无明显关系。复发也是影响患者术后KPS改善的因素。
Objective To investigate the influencing factors of postoperative quality of life in adult supratentorial low grade gliomas (WHO Ⅱ). Methods The clinical data of 115 patients with low grade gliomas confirmed by pathology after operation from October 2008 to May 2010 were retrospectively analyzed. The patients were followed up for 6 to 24 months. Age, gender, major clinical symptoms, lesion size, lesion size and pathological findings were used as independent variables. Postoperative Karnofsky score (KPS) was used as the dependent variable. Logistic regression analysis was used to analyze the related factors. KPS differences between different groups were compared using rank sum test. Results The patients were followed up to 6 months after operation. The results were statistically significant (P <0.05) in the age, lesion size, lesion location, resection scope and history of epilepsy among KPS patients. Follow-up to 12 months postoperatively, resection range and history of epilepsy had no effect on KPS score (P> 0.05). Pathological types, preoperative existence of neurological dysfunction and postoperative KPS improvement in the single factor and multivariate comparison was not statistically significant. Conclusions Patients with age ≤50 years, preoperative epilepsy history, tumor diameter ≤4cm, superficial lesions and total resection have a better KPS improvement than those with age> 50 years, no preoperative epilepsy history, tumor diameter> 4cm, Deep in, subtotal tumor patients. There was no significant correlation between preoperative neurological dysfunction and pathological type and postoperative quality of life. Recurrence is also a factor that affects the improvement of postoperative KPS in patients.