脑动静脉畸形术后癫癎发生的危险因素分析

Risk factor analysis for postoperative seizure in patients with brain arteriovenous malformation

目的探讨脑动静脉畸形(AVM)术后癫癎发生的危险因素。方法回顾性分析接受手术并有完整临床资料的脑动静脉畸形病例138例,以性别、年龄、主要症状、阳性体征、术前癫癎史、病变部位、畸形团大小、引流静脉、手术入路、术后水肿、病灶残留、手术次数、癫癎灶切除等13项可能的影响因素为自变量,设定术后发生癫癎为因变量,使用Logistic逐步回归分析研究相关的影响因素。结果术前癫癎史、病变部位、畸形团大小、引流静脉、术后水肿等5个因素是术后癫癎发生的危险因素。结论对脑动静脉畸形手术病人,应针对癫癎发生危险因素进行防治,以减少脑动静脉畸形术后癫癎的发生。

Objective To explore the risk factors for post operative seizure in patients with brain arteriovenous malformation （AVM）. Methods One hundred and thirty eight patients receiving cranial surgery for brain AVM with complete clinical data were analyzed retrospectively. Thirteen factors were chosen as independent variables such as gender, age, predominant symptoms, positive signs, history of preoperative seizure, AVM location, size of AVM, draining vein, surgical approaches, postoperative edema, residual AVM, number of operation, excision of epileptogenic focus; the occurrence of postoperative seizure was used as the dependent variable, and the risk factors for postoperative seizure were analyzed by regression analysis. Results History of preoperative seizure, AVM location, size of AVM, draining vein, postoperative edema were identified as the risk factors for postoperative seizure in brain AVM patients. Conclusion Patients with brain AVM should be treated carefully targeting the risk factors of postoperative seizure to decrease occurrence of seizure.