脑胶质瘤术后血管周围间隙改变的影响因素研究

Study on the factors influencing the changes of perivascular space after glioma surgery

目的探讨脑肿瘤术后血管周围间隙(PVS)改变的危险因素。方法根据是否发生术后PVS改变,将80例脑胶质瘤患者分为PVS组38例(观察组)与术后PVS正常组42例(对照组)。比较2组患者的一般资料、手术、肿瘤相关指标以及术后并发症发生情况,并对脑肿瘤术后PVS改变的影响因素进行分析。结果观察组患者手术时间(95.38±9.21)min,较对照组(75.36±9.05)min明显延长,观察组术中出血量为(290.32±45.47)m L较对照组的(247.19±36.75)m L明显增加,2组比较差异均有统计学意义(P<0.05)。观察组中肿瘤部位位于左侧大脑半球、肿瘤体积超过40.0 cm3、高级别胶质瘤、术后出现并发症的患者所占比例均明显高于对照组,2组比较差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄、肿瘤部位、肿瘤体积、病理级别以及并发症的发生情况与胶质瘤患者术后PVS改变发生显著相关(P<0.05)。结论高龄、肿瘤位于大脑左侧、肿瘤体积大、病理严重以及术后发生癫痫、慢性颅内压增高等并发症是影响胶质瘤患者术后PVS改变的危险因素。

Objective To investigate the risk factors of perivascular space change after brain tumor surgery. Methods According to the occurrence of postoperative perivascular space change, 80 cases of glioma patients were divided into perivascular space and reconstruction group （ observation group, n = 38 ） and normal postoperative perivascular space group （ control group, n = 42 ）. Compared the general data, surgery, tumor related indicators and postoperative complications of the two groups, and analyzed the influencing factors of the perivascular space changes after brain tumor surgery. Results In the observation group, the operation time of the patients was （ 95.38 ± 9.21 ） rain, which was significantly longer than （ 75.36 ± 9.05 ） rain in the control group. The intraoperative blood loss was （290.32 ± 45.47 ） mL in the observation group,which was significantly more than （247. 19 ±36. 75 ） mL in the control group, and the difference was statistically significant （ P 〈 0. 05 ）. The tumor site located in the left hemisphere, tumor volume more than 40.0 cm^3 , high grade glioma, and proportion of patients with postoperative complications in the observation group were all higher than those of the control group, and the difference between the two groups was statistically significant（ P 〈 0.05 ）. Multivariate Logistic regression analysis showed that age, tumor location, tumor volume, pathological grade and complications were significantly correlated with the changes of perivaseular space after surgery （P 〈 0.05 ）. Conclusion Advanced age, tumor located in the left side of the brain, large tumor volume, severe pathology, postoperative epilepsy, chronic intracranial hypertension and other complications were the risk factors affecting the changes of perivaseular space in patients with glioma.