脑胶质瘤术后早期癫痫发作相关危险因素的Logistic回归分析

Logistic Regression Analysis of Risk Factors Related to Early Seizure after Glioma Surgery

目的:探讨脑胶质瘤术后早期癫痫发作的相关危险因素,为改善脑胶质瘤患者手术预后,提高术后生活质量提供参考。方法:采用以医院为基础的回顾性病例对照设计,连续收集2017年3月至2018年2月在四川大学华西医院行开颅脑胶质瘤切除手术的322例患者,进一步按照是否合并早期癫痫发作分为病例组和对照组,收集患者的临床病理资料,采用多因素Logistic回归模型分析脑胶质瘤术后早期癫痫发作的相关危险因素。结果:单因素分析显示,术前癫痫发作频率、术前运动障碍、手术切除程度、病理分级、肿瘤位置、肿瘤大小、术后瘤腔出血、手术前后预防性抗癫痫用药是脑胶质瘤术后早期癫痫发作的危险因素(均≥0.05);多因素Logistic回归分析显示:术前癫痫发作频率(≥1次/d)、术前有运动障碍、病理分级(Ⅱ级)、肿瘤大小(≥5cm)、手术前无预防性抗癫痫用药、手术后无预防性抗癫痫用药是脑胶质瘤术后早期癫痫发作的独立危险因素(均P<0.05)。结论:临床治疗应针对脑胶质瘤术后早期癫痫发作的危险因素,采取合理预防对策,进行个体化评估与治疗,以降低术后早期癫痫发作的风险。

Objective:To explore the risk factors of early epileptic seizures after glioma surgery,so as to improve the prognosis and quality of life of patients with gliomas.Methods:A hospital-based prospective case-control design was used to continuously collect 322 patients who underwent glioma resection at West China Hospital from March 2017 to February 2018.The patients with or without early seizures were further assigned to the case group and the control group.Clinical and pathological data of the patients were collected.And multivariate logistic regression model was used to analyze the risk factors associated with early seizures caused by glioma.Results:Univariate analysis showed that the frequency of preoperative seizure,preoperative dyskinesia,resection degree,pathological grade,tumor location,tumor size,postoperative cavity hemor-rhage,preoperative use of prophylactic antiepileptic drugs were the risk factors for early seizure of gliomas after surgery(all P<0.05);multivariate logistic regression analysis showed that the frequency of preoperative seizure(≥1 time/d),preoperative dyskinesia,grade Ⅱ,tumor size ≥5cm and no history of prophylactic antiepileptic drugs before and after operation were independent risk factors of early epilepsy after glioma operation(P<0.05).Conclusion:In order to reduce the risk of early epilepsy after glioma surgery,reasonable preventive measures and individualized evaluation and treatment are recommended.