摘要
目的探讨老年脑肿瘤患者围术期神经认知障碍(PND)发生的影响因素及康复治疗的有效性。方法回顾性分析新疆医科大学第一附属医院2020年12月至2022年7月收治的120例老年脑肿瘤患者的临床资料,按是否发生PND将患者分为PND组(n=78)和非PND组(n=42),比较两组人口学信息及相关临床指标。按照干预方式,将PND组患者分为对照组(n=41)与观察组(n=37),比较不同干预方法在改善PND患者神经认知功能及生活质量中的效果。采用SPSS 22.0统计软件进行数据处理。根据数据类型,分别采用t检验或χ^(2)检验进行组间比较。采用多因素logistic回归模型分析老年脑肿瘤患者发生PND的影响因素。结果老年脑肿瘤患者PND发生率为65.0%(78/120)。PND组与非PND组患者年龄、肿瘤部位、WHO肿瘤病理分级及肿瘤体积比较,差异有统计学意义(P<0.05)。治疗后,观察组中文版蒙特利尔认知评估量表(MoCA)评分高于对照组;角色、躯体、社会及情绪功能评分高于对照组,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示:老年脑肿瘤患者PND发生的影响因素为肿瘤部位(OR=1.879,95%CI 1.103~3.203)、WHO肿瘤病理分级(Ⅱ级:OR=1.964,95%CI 1.021~3.780;Ⅲ级:OR=2.186,95%CI 1.099~4.349;Ⅳ级:OR=2.462,95%CI 1.162~5.216)及肿瘤体积(20~<40 cm 3:OR=1.793,95%CI 1.016~3.166;40~<60 cm 3:OR=2.038,95%CI 1.114~3.727;≥60 cm 3:OR=2.207,95%CI 1.207~4.298)。结论老年脑肿瘤患者PND发生率较高,尤以肿瘤部位处于额颞叶、WHO肿瘤病理分级高及肿瘤体积大的脑肿瘤患者为高危人群,需重点关注,在PND发生后,给予康复治疗有利于神经认知功能的改善。
Objective To explore the influencing factors of perioperative neurocognitive disorders(PND)in the elderly patients with brain tumors and effectiveness of rehabilitation treatment.Methods A retrospective analysis was made of the clinical data of 120 elderly brain tumor patients admitted to First Affiliated Hospital of Xinjiang Medical University from December 2020 to July 2022.Based on whether they experienced PND,the patients were divided into PND group(n=78)and non-PND group(n=42).The two groups were compared in the demographic information and clinical indicators.According to the intervention methods,the PND patients were classified into the control group(n=41)and the observation group(n=37).The two groups were compared in the effects of different intervention methods on improving neurocognitive function and quality of life.SPSS statistics 22.0 was used to process the data,and according to the type of data,t test orχ^(2) test was used for inter-group comparison.Logistic regression model was used to analyze the factors affecting the PND in the elderly patients with brain tumors.Results The incidence of PND in 120 elderly patients with brain tumors was 65.0%(78/120).There was a statistically significant difference in age,tumor location,WHO pathological tumor grading,and tumor volume between PND group and non-PND group(P<0.05).After treatment,the Montreal cognitive assessment(MoCA)score,and the role,physical,social and emotional functions scores in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that the factors affecting the occurrence of PND in the elderly brain tumor patients were tumor site(OR=1.879,95%CI 1.103-3.203),WHO′s pathological tumor grading(levelⅡ:OR=1.964,95%CI 1.021-3.780;levelⅢ:OR=2.186,95%CI 1.099-4.349;levelⅣ:OR=2.462,95%CI 1.162-5.216)and tumor volume(20-<40 cm 3:OR=1.793,95%CI 1.016-3.166;40-<60 cm 3:OR=2.038,95%CI 1.114-3.727;≥60 cm 3:OR=2.207,95%CI 1.207-4.298).Conclusion The incidence of PND is relatively high in the elderly patients with brain tumors,especially in those with tumors located in the frontal and temporal lobes,high grades on WHO tumor classification and large tumor volumes,and high-risk groups require special attention.After the onset of PND,rehabilitation therapy can help improve neurocognitive function.
作者
赵新静
张洋
许倩倩
沙娅·玛哈提
Zhao Xinjing;Zhang Yang;Xu Qianqian;Shaya·Mahati(VIP Zone for Officials,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China;First Department of Oncology Center,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China;Department of General Surgery/Special Surgery,First Affiliated Hospital,Xinjiang Medical University,Urumqi 830054,China)
出处
《中华老年多器官疾病杂志》
2024年第3期166-169,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
国家自然科学基金(82160034)。
关键词
老年人
脑肿瘤
神经认知障碍
康复治疗
aged
brain tumor
neurocognitive disorders
rehabilitation therapy
