脑膜瘤继发癫痫患者术后发作控制效果的影响因素

Influential Factors of Postoperative Seizure Control in Patients with Meningioma Secondary Epilepsy

目的探讨脑膜瘤继发癫痫患者术后癫痫发作控制效果的影响因素。方法回顾性分析2013年1月~2018年6月于唐都医院神经外科行脑膜瘤手术的29例患者的临床资料,根据治疗后Engel分级将患者分为EngelⅠ级组、EngelⅡ级组,比较两组一般资料、术前用药、发作类型、肿瘤情况(位置、大小、质地、水肿情况、粘连情况、血供情况)、手术时间、术后病理及住院天数,单因素和多因素分析影响术后癫痫发作控制效果的因素。结果EngelⅠ级组19例,EngelⅡ级组10例。单因素分析显示,两组性别、发作类型、肿瘤直径、瘤周水肿程度、位于矢状窦旁、肿瘤质地及手术时间比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,癫痫呈部分性发作和肿瘤位于矢状窦旁是脑膜瘤继发癫痫患者术后发作控制效果的独立影响因素。结论肿瘤位置位于矢状窦旁以及癫痫呈部分性发作是脑膜瘤继发癫痫患者术后发作控制效果的影响因素,临床上针对此类患者应予以重视。

Objective To explore the influencing factors of postoperative seizure control in patients with meningioma secondary epilepsy.Methods The clinical data of 29 patients who underwent meningiomas in neurosurgery at Tangdu Hospital from January 2013 to June 2018 were retrospectively analyzed,according to the Engel classification after treatment,patients were divided into EngelⅠgroup and EngelⅡgroup,compared the general information,preoperative medication,type of attack,tumor condition(location,size,texture,edema,adhesion,blood supply),operation time,postoperative pathology,and length of hospital stay,univariate and multifactorial analysis of factors affecting the effect of postoperative seizure control.Results There were 19 cases in EngelⅠgroup and 10 cases in EngelⅡgroup.Univariate analysis showed that there were significant differences in gender,type of attack,tumor diameter,degree of peritumor edema,location of sagittal sinus,tumor texture,and operation time between the two groups(P<0.05).Multivariate Logistic regression analysis showed partial seizures and tumors located next to the sagittal sinus are independent factors influencing postoperative seizure control in patients with meningioma secondary epilepsy.Conclusion The tumor location near the sagittal sinus and partial seizures are influential factors for postoperative seizure control in patients with meningioma secondary epilepsy,which should be paid attention to clinically.