老年与中青年皮质中央区脑膜瘤患者的临床特点及手术效果差异分析

Differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area

目的探讨老年与中青年皮质中央区脑膜瘤患者的临床特点及手术效果差异。方法选择广东三九脑科医院神经外科自2011年1月至2020年12月手术治疗的43例老年(年龄≥60岁)皮质中央区脑膜瘤患者(老年组)与63例中青年(年龄18~59岁)皮质中央区脑膜瘤患者(中青年组)为研究对象,分析2组患者间症状体征、肿瘤大小、瘤周水肿程度、术中出血量、肿瘤切除程度、并发症、住院天数等方面的差异。结果老年组患者中术前肌力下降比例明显高于中青年组,头痛比例明显低于中青年组,肿瘤体积较中青年组更大,手术前后瘤周水肿程度较中青年组更严重,术中出血量明显少于中青年组,住院天数明显高于中青年组,差异均有统计学意义(P<0.05),但2组患者间肿瘤切除Simpson分级分布、新发神经功能障碍比例、术后并发症发生率、再次手术及肿瘤复发比例的差异均无统计学意义(P>0.05)。老年组中不同WHO分级患者间瘤周水肿程度分布的差异有统计学意义(P<0.05),中青年组中不同肿瘤大小患者间瘤周水肿程度分布的差异有统计学意义(P<0.05)。结论老年与中青年皮质中央区脑膜瘤患者间虽有临床特点方面的差异,但两者手术效果方面却并无显著差异。老年患者的瘤周水肿程度与肿瘤病理分级有关,而中青年患者与肿瘤大小有关。

Objective To explore the differences of clinical features and surgical efficacy between the elderly and the middle-aged and young patients with meningiomas in the central cortex area.Methods Forty-three elderly patients with meningiomas in the central cortex area(≥60 years old)and 63 middle-aged and young patients with meningiomas in the central cortex area(18-59 years old),accepted surgery in Department of Neurosurgery,Guangdong 999 Brain Hospital from January 2011 to December 2020,were chosen.The differences of symptom,gross tumor volume,peritumoral edema degrees,intraoperative blood loss,tumor resection degrees,complications,and hospital stays between the 2 groups were analyzed.Results The elderly patients had significantly higher proportion of preoperative muscle strength decline,lower proportion of preoperative headache,larger preoperative tumor volume,more severe peritumoral edema degrees before and after surgery,small volume of intraoperative blood loss,and longer hospital stays compared with the middle-aged and young patients(P<0.05).However,no significant differences in distributions of tumor resection Simpson grades,proportion of new neurological dysfunction,incidence of postoperative complications,and proportions of reoperations and tumor recurrence were noted between the 2 groups(P>0.05).Significant difference in distributions of peritumoral edema degrees among patients with different WHO grades was noted in the elderly group(P<0.05),and significant difference in distribution of peritumoral edema degrees among patients with different tumor volumes was noted in the middle-aged and young group(P<0.05).Conclusions Although differences in clinical characteristics exist between the elderly and the middle-aged and young patients with meningiomas in the central cortex area,no significant difference in surgical efficacy is noted between the 2 groups.The peritumoral edema degree in the elderly patients is related to tumor pathological grades,while that in middle-aged and young patients is related to tumor volumes.