發(fā)布時間：2018-06-03 08:42

  本文選題：腦膜瘤 + 流行病學(xué)　； 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：目的:總結(jié)并分析顱內(nèi)腦膜瘤的流行病學(xué)特征,術(shù)后并發(fā)癥特點(diǎn)及導(dǎo)致術(shù)后并發(fā)癥的因素,為顱內(nèi)腦膜瘤的臨床研究和治療提供幫助。方法:按照WHO 2016年中樞神經(jīng)系統(tǒng)腫瘤分類標(biāo)準(zhǔn)納入病例,回顧性分析2012年1月至2016年12月鄭州大學(xué)第一附屬醫(yī)院神經(jīng)外科收治的,病理診斷為顱內(nèi)腦膜瘤的病例2384例,對患者的性別、年齡、地區(qū)分布、臨床表現(xiàn)、腫瘤部位、腫瘤大小、手術(shù)切除程度、病理類型、術(shù)后并發(fā)癥等流行病學(xué)特征進(jìn)行描述,兩組定性資料間比較采用χ2檢驗,應(yīng)用多因素logistic回歸分析導(dǎo)致術(shù)后并發(fā)癥的相關(guān)因素。然后結(jié)合臨床及相關(guān)文獻(xiàn),總結(jié)顱內(nèi)腦膜瘤流行病學(xué)特點(diǎn)和治療經(jīng)驗。結(jié)果:2384例顱內(nèi)腦膜瘤患者男女之比為1:2.48,各年齡組女性病例數(shù)均高于男性�；颊吣挲g最小7歲,最大88歲,平均52.9±12.2歲,發(fā)病高峰年齡組為50~59歲。河南省內(nèi)患者地區(qū)分布最多的是豫南地區(qū)(26.1%)。腫瘤最小0.4cm,最大12.3cm,平均3.8±1.5cm。腫瘤起源位置最多的是大腦鐮及矢狀竇(25.3%)。最常見的臨床表現(xiàn)是頭痛頭昏。以SimpsonⅠ級/SimpsonⅡ級切除為標(biāo)準(zhǔn),切除率最高的腫瘤部位為幕上凸面(91.9%)。病理分級WHOⅠ級腦膜瘤1925例(80.7%),WHOⅡ級420例(17.6%),WHOⅢ級39例(1.6%)。術(shù)后最常見的神經(jīng)系統(tǒng)并發(fā)癥為顱內(nèi)出血(9.1%)。患者年齡≥60歲,術(shù)前KPS≤70分,腫瘤長徑≥7cm、腫瘤位于鞍區(qū)或其他罕見部位(海綿竇、視神經(jīng)鞘、枕骨大孔區(qū)及頸靜脈孔區(qū)等),SimpsonⅡ級,SimpsonⅢ級,SimpsonⅣ切除為導(dǎo)致術(shù)后并發(fā)癥的獨(dú)立危險因素。發(fā)生術(shù)后并發(fā)癥的風(fēng)險隨手術(shù)切除程度的降低而升高,在年齡≥60歲時隨年齡升高而升高。結(jié)論:顱內(nèi)腦膜瘤有其流行病學(xué)及臨床特征:女性高發(fā),發(fā)病高峰有提前趨勢,本中心患者最多來自于豫南地區(qū),大腦鐮和矢狀竇旁高發(fā),最常見的癥狀為頭痛頭昏,最常見的術(shù)后神經(jīng)系統(tǒng)并發(fā)癥為顱內(nèi)出血等。患者年齡≥60歲、術(shù)前KPS≤70分、腫瘤≥7cm、腫瘤位于鞍區(qū)或其他罕見部位(海綿竇、原發(fā)視神經(jīng)鞘、枕骨大孔區(qū)及頸靜脈孔區(qū)等)及SimpsonⅡ/Ⅲ/Ⅳ級切除為發(fā)生術(shù)后并發(fā)癥的獨(dú)立危險因素。發(fā)生術(shù)后并發(fā)癥的危險性隨手術(shù)切除程度的降低而升高,在年齡≥60歲時隨年齡升高而升高。腦膜瘤的治療應(yīng)合理評估患者術(shù)前情況,避免這些產(chǎn)生術(shù)后并發(fā)癥的危險因素。對術(shù)后并發(fā)癥,應(yīng)根據(jù)情況密切觀察或?qū)ΠY治療。
[Abstract]:Objective: to summarize and analyze the epidemiological characteristics, postoperative complications and factors leading to postoperative complications of intracranial meningiomas, and to provide help for the clinical study and treatment of intracranial meningiomas. Methods: according to the WHO 2016 criteria for classification of central nervous system tumors, 2384 cases of intracranial meningioma were retrospectively analyzed from January 2012 to December 2016 in the Neurosurgery Department of the first affiliated Hospital of Zhengzhou University. Sex, age, regional distribution, clinical manifestation, tumor location, tumor size, surgical resection degree, pathological type, postoperative complications and other epidemiological features were described. The qualitative data of the two groups were compared by 蠂 2 test. Multivariate logistic regression analysis was used to analyze the related factors of postoperative complications. Then the epidemiological characteristics and treatment experience of intracranial meningioma were summarized in combination with clinical and related literature. Results the ratio of male to female was 1: 2.48 in 2 234 cases of intracranial meningioma. The number of female cases in each age group was higher than that in male group. The average age of the patients was 52.9 鹵12.2 years. The peak age group was 50 to 59 years old. In Henan Province, the distribution of patients is the most in the south of Henan Province. The tumor was the smallest 0.4 cm and the maximum 12.3 cm, with an average of 3.8 鹵1.5 cm. Most of the tumors were located in the cerebral falx and sagittal sinus. The most common clinical manifestation is headache and dizziness. According to the standard of Simpson 鈪，

本文編號：1972172