显微外科手术治疗矢状窦大脑镰旁脑膜瘤效果及预后影响因素分析

Effect of Microsurgical Treatment of Parasagittal and Parafalcine Meningiomas and Analysis of Prognostic Factors

目的探讨显微外科手术治疗矢状窦大脑镰旁脑膜瘤效果并分析影响预后的相关因素。方法回顾性分析2013年4月—2021年1月接受显微外科手术治疗的矢状窦大脑镰旁脑膜瘤52例的临床资料,术后随访3~12个月,应用Karnofsky功能状态评分量表(KPS)对术后患者进行分组,KPS评分≥90分为预后良好组,KPS评分<90分为预后不良组。比较2组术前症状、肿瘤特征、Simpson分级、术后并发症和复发情况,并分析影响预后的相关因素。结果52例中预后良好35例,预后不良17例。术后出现颅内出血、颅内感染和肿瘤复发各1例。多因素Logistic回归分析显示,肿瘤直径、Simpson分级和术前运动障碍是矢状窦大脑镰旁脑膜瘤患者术后预后不良的独立危险因素(P<0.05)。结论显微外科手术能够有效改善矢状窦大脑镰旁脑膜瘤患者预后,具有较高的全切率,但肿瘤直径、Simpson分级和术前运动障碍可影响患者预后。

Objective To investigate the effect of microsurgery in the treatment of parasagittal and parafalcine meningiomas and to analyze the relevant prognostic factors.Methods We retrospectively analyzed the clinical data of 52 patients with parasagittal and parafalcine meningiomas treated by microsurgery from April 2013 to January 2021,and followed them up for 3 to 12 months after surgery.The patients were scored and grouped by Karnofsky Performance Status Score Scale(KPS),and the patients with KPS score≥90 were classified as good prognosis group,while those with KPS score<90 were classified as poor prognosis group.The preoperative symptoms,tumor characteristics,Simpson grading,postoperative complications and recurrence were compared between the two groups,and the influencing factors of the prognosis were analyzed.Results Among 52 cases,35 cases had good prognosis and 17 cases had poor prognosis.There was one case of intracranial hemorrhage,one case of intracranial infection and one case of tumor recurrence after surgery.Multivariate logistic regression analysis showed that tumor diameter,Simpson grading and preoperative motor disorder were independent risk factors for poor postoperative prognosis in patients with parasagittal and parafalcine meningiomas(P<0.05).Conclusion Microsurgery can effectively improve the prognosis of patients with parasagittal and parafalcine meningiomas with a high rate of total resection,but tumor diameter,Simpson grading and preoperative motor disorders can affect the prognosis of patients.