颅内肿瘤患者智力损害的评价及术后随访

Preoperative and postoperative assessment of intelligence for intracranial tumor patients

目的 评价颅内肿瘤及神经外科手术对患者智力的影响.方法 运用中国修订韦氏成人智力量表（WAIS-RC）对79例颅内肿瘤患者进行智力评估.按照简式（四合一）算法换算智商（IQ）、言语智商（VIQ）和操作智商（PIQ）.结果 脑叶内肿瘤患者术前IQ（P＜0.01）、VIQ（P＜0.01）均显著低于健康对照组;优势半球肿瘤组术前IQ、VIQ明显低于健康对照组和非优势半球组;鞍区肿瘤组患者无智力受损.术后凸面脑外肿瘤组IQ、PIQ均降低.结论 颅内肿瘤可导致患者智力损害,脑叶内肿瘤及优势半球肿瘤所致智力损害较严重;神经外科医生应重视颅内肿瘤及其手术对患者智力的影响.

Objective To analyze the effects of intracranial tumors and tumor resection on patients＇ intelligence.Methods Chinese modified WAIS-RC was used to assess intelligence of 79 intracranial tumor patients and 18 health controls （HC） and then intelligence quotient （IQ）,verbal IQ （VIQ） and performance IQ （PIQ） were calculated by short form algorithm （4 in 1）.Results Intracerebral tumor patients presented a lower preoperative IQ （P〈0.01） and VIQ （P〈0.01） than control group.Dominant hemispheric tumor group＇s preoperative IQ,VIQ were much lower than those of control group and nondominant hemispheric tumor group.Patients with sellar region tumors had no significance on intelligence compared with control group.Transsphenoidal approach had no effect on IQ.Extra-cerebral tumor group presented with lower IQ and PIQ after tumor resection.Conclusions Intracranial tumors could result in intelligence impairment,especially in VIQ impairment.Dominant hemispheric tumors patients have more serious intelligence deficits than non-dominant hemispheric tumors patients.Neurosurgeon should pay more attention to the effects of brain tumors and surgery on intelligence.