手术切除脑膜瘤后复发的危险因素分析及手术对策研究

Risk Factors and Surgical Countermeasures for Recurrence of Meningioma after Surgical Resection

目的分析手术切除脑膜瘤后复发的危险因素,探讨研究适合脑膜瘤患者的手术方式。方法回顾性分析进行手术治疗后复发的160例脑膜瘤患者临床资料,分别对其进行单因素和多因素分析,总结影响手术后再复发的非手术因素和手术因素。结果年龄、术前是否发生癫痫、术前KPS评分与脑膜瘤患者术后的复发无相关性,性别、肿瘤形状、病理类型、肿瘤直径以及是否初发是影响脑膜瘤患者术后复发的重要因素(P<0.05);对脑膜瘤术后患者复发的手术因素分析看出:手术治疗方式(单纯手术、γ刀、手术+放疗、手术+γ刀)与手术切除程度(SimpsonⅠ级、Ⅱ级、Ⅲ级)是影响脑膜瘤患者术后复发的重要的手术因素(P<0.05)。经Logistic回归分析,病理类型、手术治疗方式、肿瘤直径、手术切除程度、是否初发、肿瘤形状以及性别是影响脑膜瘤患者术后复发的重要因素。结论重视影响术后复发的手术因素,对于提高脑膜瘤患者的临床疗效、降低术后复发率具有重要的临床意义。

Objective To explore the risk factors for recurrence of meningioma after surgical resection and suitable surgical approach.Methods Clinical data of 160 cases of meningioma were retrospectively analyzed.Univariate and multivariate factor analysis were conducted to analyze non-surgical factors and surgical factors which affect recurrence.Results Age,preoperative seizures,preoperative KPS score were not related with postoperative recurrence of meningioma,gender,tumor shape,histological type,tumor size,and onset were important factors affecting postoperative recurrence of meningioma(P < 0.05); postoperative surgical factors analysis showed surgical treatment(surgery alone,γ knife,surgery plus radiotherapy,surgery + γ knife) and extent of surgical resection(SimpsonⅠ grade,Ⅱ,Level Ⅲ) were important surgical factors affecting recurrence(P < 0.05); Logistic regression analysis showed that histological type,surgical treatment,tumor size,extent of surgical resection,onset,tumor shape and gender were important factors affecting postoperative recurrence of meningioma.Conclusion Surgical factors affecting recurrence can improve the clinical efficacy of meningioma patients,and reduce the recurrence rate.