颈动脉体瘤切除术后颅神经损伤相关并发症危险因素分析

Analyses of risk factors for postoperative cranial nerve injury complications following carotid body tumor resection

目的探讨颈动脉体瘤(CBT)切除术后发生神经损伤并发症的相关危险因素。方法回顾性分析2011年1月至2020年12月西安交通大学第一附属医院收治的69例CBT患者的临床资料,对可能与术后神经损伤相关并发症发生的因素进行单因素分析,对单因素分析差异有统计学意义的因素,采用多因素logistic回归分析其与术后神经损伤相关并发症的相关性。结果69例中21例发生术后神经损伤,发生率为30.43%。根据是否发生术后神经损伤,将患者分为神经损伤组(观察组,n=21)和未发生神经损伤组(对照组,n=48)。单因素分析显示天门冬氨酸转氨酶、丙氨酸转氨酶、Shamblin分型、发病时间、颈外动脉结扎及中性粒细胞与淋巴细胞比值是CBT切除术后神经损伤的相关危险因素。多因素logistic回归分析结果显示颈外动脉结扎、Shamblin分型是发生术后神经损伤相关并发症的独立危险因素。结论术中颈外动脉结扎、Shamblin分型是CBT切除术后发生神经损伤并发症的独立危险因素。

objective To analyze the risk factors for postoperative cranial nerve injury complications following carotid body tumor resection(CBTR).Methods The clinical data of 69 patients who had undergone CBTR in the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2020 were retrospectively analyzed.Univariate analysis was performed on the related factors for postoperative cranial nerve injury complications.Unconditional binary multivariate logistic regression was used to analyze the correlation between the related factors with statistical significance in univariate analysis and the postoperative cranial nerve injury complications.Results Among 69 patients,there were 21 patients who developed postoperative cranial nerve injury,with incidence being 30.43%.Patients were divided into nerve injury group(observation group,n=21)and non-nerve injury group(control group,n=48)according to whether postoperative cranial nerve injury occurred.Univariate analysis showed aspartate transaminase(AST),alanine aminotransferase(ALT),Shamblin classification,onset time,external carotid artery ligation and neutrophil to lymphocyte ratio(NLR)were risk factors for postoperative cranial nerve injury following CBTR.Multivariate logistic regression analysis identified Shamblin classification and external carotid artery ligation as independent risk factors for postoperative cranial nerve injury complications.Conclusions Intraoperative external carotid artery ligation and Shamblin classification are independent risk factors for postoperative cranial nerve injury following CBTR.