影响脊髓海绵状血管瘤手术后长期神经功能的多因素回归分析

Multivariate regression analysis of factors on long-term neurological function recovery of spinal cord cavernous hemangiomas

目的探讨影响脊髓海绵状血管瘤术后长期神经功能恢复的临床因素。方法采用单因素与多因素分析方法，回顾性分析55例具有完整脊髓海绵状血管瘤患者的临床资料及其2年后的神经功能恢复情况。结果28例（50．9％）患者Aminoff-Logue评分至少较术前提高1个等级，14例（25．5％）患者等级无明显改变，13例（23．6％）较术前至少退步1个等级。Logistic回归分析发现患者临床类型（OR=3．27，95％C／2．34—15．83，P：0．006）、初次发病至手术时间（OR=2．93，95％C／1．41～10．61，P=0．012）、末次发病至手术时间（OR=4．31，95％C／2．46～12．32，P=0．019）与术后长期神经功能恢复独立相关。结论对于出现功能障碍的脊髓海绵状血管瘤患者，不管何种临床类型及神经功能障碍程度，均应在发病后早期行手术治疗，以改善术后神经功能的恢复。

Objective To explore the clinical factors on the functional recovery of spinal cord cavernous hemangioma operation. Methods Fifty cases patients with complete spinal cord cavernous hemangioma were retrospectively analyzed their clinical data and its influence on prognosis of 2 years. Single factor and multiple factors analysis were performed. Results Compared with the preoperative stage, the grade of Aminoff-Logue score of 28 cases （ 50. 9% ） had improved at least one grade, 14 cases （ 25.5% ） patients with no significant changes and 13 cases（23.6% ） with decreased one grade at least. Logistic regression model showed that patients with clinical types （ OR = 3.27,95% CI 2. 34 - 15.83, P = 0. 006 ）, the time of the attacks to the surgery （ OR = 2. 93,95 % CI 1.41 - 10. 61, P = 0. 012 ）, and the attacks to the operation time （ OR = 4. 31,95 % CI 2.46 - 12. 32, P = 0.019 ） were related to neurological function recovery of spinal cord cavernous hemangiomas. Conclusion For patients with SCH dysfunction, regardless of what kind of clinical types of neurological dysfunction extent, should receive surgical treatment to improve neurological function recovery rate as soon as possible.