摘要
目的探讨显微手术对脑胶质瘤患者血清因子、认知功能及日常生活能力的影响。方法根据手术方式的不同将118例脑胶质瘤患者分为观察组和对照组,每组59例,对照组患者进行传统开颅肿瘤切除术,观察组患者进行显微镜下肿瘤切除术。比较两组患者的围手术期指标、血清因子[催产素(OT)、β-内啡肽(β-EP)、精氨酸加压素(AVP)和肿瘤坏死因子-α(TNF-α)]水平、认知功能[简易精神状态检查表(MMSE)]和日常生活能力[日常生活活动能力量表(ADL)]。结果观察组患者的手术时间、住院时间、术后首次下床活动时间、切口长度均明显短于对照组,术中出血量明显少于对照组,差异均有统计学意义(P﹤0.01)。术后3个月,两组患者的OT、β-EP、AVP、TNF-α水平均低于本组术前,观察组患者的OT、β-EP、AVP水平均高于对照组,差异均有统计学意义(P﹤0.05);术后3个月,两组患者的TNF-α水平比较,差异无统计学意义(P﹥0.05)。术后3、6个月,两组患者语言能力、记忆能力、定向力评分和ADL评分均高于本组术前,且观察组患者的上述评分均高于对照组,差异均有统计学意义(P﹤0.05)。结论采用显微手术对脑胶质瘤患者血清因子的影响较小,且可有效提高患者的认知功能和日常生活能力。
Objective To investigate the effect of microsurgical treatment on serum factor levels,cognitive function,and ability of daily living in patients with glioma.Method A total of 118 patients with glioma were divided into observation group and control group according to different surgical methods,with 59 cases in each group.Patients in the control group underwent traditional craniotomy for tumor resection,while patients in the observation group underwent microscopic tumor resection.Perioperative indicators,serum factors[oxytocin(OT),β-endorphin(β-EP),arginine vasopressin(AVP),and tumor necrosis factor-α(TNF-α)]levels,cognitive function[mini-mental state examination(MMSE)],and daily living activities[activity of daily living scale(ADL)]were compared between the two groups.Result The operation time,hospital stay,postoperative first ambulation time,and incision length of the observation group were significantly shorter than those of the control group,and the intraoperative blood loss volume was significantly less than that of the control group,the differences were statistically significant(P<0.01).Three months after the operation,the levels of OT,β-EP,AVP,and TNF-α in the two groups were lower than those before the operation,and the levels of OT,β-EP,AVP in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Three months after the operation,there was no significant difference in the levels of TNF-α between the two groups(P>0.05).At 3 months and 6 months after the operation,the scores of language ability,memory ability,orientation ability,and ADL of the two groups were higher than those before the operation,and the foregoing scores of the observation group were higher than those of the control group,the differences were statistically significant(P<0.01).Conclusion Microsurgical treatment of glioma has little effect on serum factors of patients,and could effectively improve the cognitive function and daily living ability of patients.
作者
李万军
李智鹏
王万卿
任增玺
LI Wanjun;LI Zhipeng;WANG Wanqing;REN Zengxi(Department of Neurosurgery,Pingdingshan the Second People’s Hospital,Pingdingshan 467000,He’nan,China;Nanchang University Queen Mary School,Nanchang 330000,Jiangxi,China)
出处
《癌症进展》
2022年第13期1369-1372,共4页
Oncology Progress
