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影响岩斜区和岩尖后表面脑膜瘤手术后患者基于SF-36的健康相关生活质量的因素。

Factors of influence upon the SF-36-based health related quality of life of patients following surgery for petroclival and lateral posterior surface of pyramid meningiomas.

作者信息

Pintea B, Kandenwein J A, Lorenzen H, Boström J P, Daher F, Velazquez V, Kristof R A

机构信息

Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany; BG Universitätsklinikum Bergmannsheil Bochum, Bürkle de la Camp-Platz 1, 44789 Bochum, Germany.

Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany.

出版信息

Clin Neurol Neurosurg. 2018 Mar;166:36-43. doi: 10.1016/j.clineuro.2018.01.016. Epub 2018 Jan 31.

Abstract

OBJECTIVE

To describe the patient's self assessed health related quality of life (saHRQoL) based upon the medical outcome study 36-item short form health survey (SF-36) as well as the factors of influence upon the saHRQoL following surgery for petroclival (PCM) and lateral posterior surface of the pyramid (LPPM) meningiomas.

PATIENTS AND METHODS

In a series of 78 patients operated consecutively for PCM (n = 46) or LPPM (n = 32) the preoperative, intraoperative and postoperative data were collected retrospectively. The saHRQoL was obtained by mailing the SF-36 questionnaire to the patients. The SF-36 data of the whole patients group was compared with a healthy population. The SF-36 data of the PCM- and LPPM were compared to each other. The influence of pre-, intra- and postoperative findings upon the SF-36 was assessed by uni- and multifactorial analysis.

RESULTS

58 (69%) out of the 78 patients answered the SF-36 questionnaire at a median postoperative follow-up of 59 months. The patients, who answered the SF-36 questionnaire, had a significant lower perioperative complication rate than those who did not (46% vs. 75%, p = 0.019). The saHRQoL of the LPPM and PCM was reduced on several sub-scales, when compared to the German reference population. The outcome of PCM is, assessed by saHRQoL as well as by conventional neurosurgical grading scales, inferior to that of LPPM. The saHRQoL of LPPM correlated in the uni- and multivariate analysis with the early postoperative KPI on the sub-scales SF1 (physical functioning) and SF5 (vitality). Accordingly, the sub-scale SF2 (role-physical) of PCM correlated with the change of the KPI from preoperative to the last follow up.

CONCLUSIONS

The saHRQoL of the evaluable patients was lower than that of the normal population. The saHRQoL score of PCM-patients was lower than that of LPPM-patients. For the future the saHRQol should be assessed routinely; It reflects the patients' perspective upon postoperative outcome and enables the comparison with other treatment modalities of these difficult to treat tumors.

摘要

目的

基于医学结局研究简明健康调查问卷(SF - 36)描述患者自我评估的健康相关生活质量(saHRQoL),以及岩斜区(PCM)和岩锥后外侧表面(LPPM)脑膜瘤手术后影响saHRQoL的因素。

患者与方法

在一系列连续接受PCM手术(n = 46)或LPPM手术(n = 32)的78例患者中,回顾性收集术前、术中和术后数据。通过向患者邮寄SF - 36问卷获取saHRQoL。将整个患者组的SF - 36数据与健康人群进行比较。比较PCM组和LPPM组的SF - 36数据。通过单因素和多因素分析评估术前、术中和术后结果对SF - 36的影响。

结果

78例患者中有58例(69%)在术后中位随访59个月时回答了SF - 36问卷。回答SF - 36问卷的患者围手术期并发症发生率显著低于未回答者(46%对75%,p = 0.019)。与德国参考人群相比,LPPM和PCM患者的saHRQoL在几个子量表上有所降低。通过saHRQoL以及传统神经外科分级量表评估,PCM的结果不如LPPM。在单因素和多因素分析中,LPPM的saHRQoL在子量表SF1(身体功能)和SF5(活力)上与术后早期关键绩效指标相关。相应地,PCM的子量表SF2(身体角色功能)与术前至最后随访时关键绩效指标的变化相关。

结论

可评估患者的saHRQoL低于正常人群。PCM患者的saHRQoL评分低于LPPM患者。未来应常规评估saHRQol;它反映了患者对术后结果的看法,并能够与这些难治性肿瘤的其他治疗方式进行比较。

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