Salo J, Niemelä A, Joukamaa M, Koivukangas J
Department of Neurosurgery, Oulu University Hospital, PL 22, 90220 Oulu, Finland.
J Neurol Neurosurg Psychiatry. 2002 Mar;72(3):373-7. doi: 10.1136/jnnp.72.3.373.
There is little reliable quantitative information on preoperative quality of life of patients with brain tumours. The aim of this study was to clarify the effect of the volume, location, and histological grade of brain tumours on the preoperative quality of life of patients.
The study population consisted of 101 successive patients with brain tumour at Oulu Clinic for Neurosurgery studied with CT or MRI for preoperative determination of tumour location and size. The Nottingham health profile (NHP) and Sintonen's 15D scale were used at that time to measure quality of life.
Tumour size did not correlate linearly with impairment of quality of life. Large tumours (>25 ml) were associated with poorer quality of life than small tumours (< or =25 ml). The patients with a tumour located on the right side or in the anterior region reported a poorer quality of life than those with a tumour on the left side or posteriorly. Quality of life assessments made by doctors using the Karnofsky performance scale showed no differences between the two hemispheres. Patients with the most malignant gliomas (grades III-IV) displayed the poorest quality of life.
Large tumours apparently damage several parts of the brain and/or raise intracranial pressure to a level that exceeds the brain's compensatory capacity. Contrary to earlier understanding, tumours in the right hemisphere seemed to be related to poorer quality of life. This effect was especially clear in the patients' subjective evaluation of their quality of life. As the location of the brain tumour thus affects perceived quality of life, any measurements of the quality of life of patients with brain tumours should take into account the location and laterality of the tumour.
关于脑肿瘤患者术前生活质量,可靠的定量信息很少。本研究的目的是阐明脑肿瘤的体积、位置和组织学分级对患者术前生活质量的影响。
研究人群包括奥卢神经外科诊所连续收治的101例脑肿瘤患者,通过CT或MRI对其进行术前肿瘤位置和大小的测定。当时使用诺丁汉健康量表(NHP)和辛托宁15D量表来测量生活质量。
肿瘤大小与生活质量损害并非线性相关。大肿瘤(>25毫升)比小肿瘤(≤25毫升)与更差的生活质量相关。肿瘤位于右侧或前部区域的患者报告的生活质量比肿瘤位于左侧或后部的患者差。医生使用卡诺夫斯基功能状态量表进行的生活质量评估显示,两个半球之间没有差异。恶性程度最高的胶质瘤(III-IV级)患者的生活质量最差。
大肿瘤显然会损害大脑的多个部位和/或将颅内压升高到超过大脑代偿能力的水平。与早期的认识相反,右半球的肿瘤似乎与较差的生活质量有关。这种影响在患者对其生活质量的主观评估中尤为明显。由于脑肿瘤的位置会影响生活质量的感知,因此对脑肿瘤患者生活质量的任何测量都应考虑肿瘤的位置和侧别。