鞍区肿瘤患者术后早期认知功能状况及影响因素分析

Cognitive function and it related factors in patients with sellar tumors

目的了解鞍区肿瘤患者术后早期认知功能水平及其影响因素。方法便利选取2018年6-12月广州市某医院神经外科住院鞍区肿瘤患者。采用一般资料调查表调查患者基本情况,采用简易精神状态检查表评估患者术后早期认知功能。利用χ2检验和t检验进行单因素分析;再对单因素分析中有意义的指标进行Logistic回归分析。结果91例鞍区肿瘤患者术后认知平均总得分为(26.21±4.56)分。31例(34.1%)鞍区肿瘤术后患者存在认知障碍。单因素分析结果表明认知正常组与存在认知障碍组在肿瘤最大直径、肿瘤类型、术前脑水肿及术后脑水肿存在显著的差异(P<0.01)。多因素结果表明颅咽管瘤(OR=9.14,95%CI:2.29~36.54,P<0.01)为鞍区肿瘤患者术后认知功能障碍的独立危险因素。结论认知功能障碍是鞍区肿瘤患者术后早期常见的临床表现。医护人员应注重评估鞍区肿瘤患者术后早期的认知功能状况,以更好地为患者提供认知康复指导。

Objective To investigate the postoperative cognitive function and to explore its related factors.Methods:By convenient sampling,patients with sellar tumors treated in neurosurgery department in a third-grade hospital in Guangzhou were included from June to December 2018.Basic information and clinical manifestations of patients were evaluated by general information questionnaire,while postoperative cognitive function was evaluated by Mini-mental State Examination.Chi-square test and T sample test were used in single factor analysis.Statistically significant factors in single factor analysis were selected and analyzed in logistic regression analysis.Results MMSE mean score of the 91 patients with sellar tumors was 26.21±4.56,and 31(34.1%)patients with sellar tumors after surgery were diagnosed with cognitive impairment.The single factor analysis showed significant differences of maximum diameter of tumors,type of tumors,preoperative hydrocephalus and postoperative hydrocephalus between cognitive normal group and cognitive impairment group(P<0.01).Logistic regression analysis showed that craniopharyngioma(OR=9.14,95%CI:2.29~36.54,P<0.01)was the main risk factor of cognitive impairment among sellar tumor patients.Conclusion Postoperative cognitive impairment was common among sellar tumor patients.Medical staff should evaluate the early cognitive function of patients with sellar tumors after operation,for offering cognitive rehabilitation suggestions.