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围手术期颅内恶性肿瘤患者综合能力评价及趋势分析。

Comprehensive ability evaluation and trend analysis of patients with malignant intracranial tumors in the perisurgery period.

机构信息

Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Brain Behav. 2021 Nov;11(11):e02192. doi: 10.1002/brb3.2192. Epub 2021 Sep 23.

Abstract

INTRODUCTION

Prognostic situations differ in patients with malignant intracranial tumors. We focused on the quality of life, ability of daily living, and cognitive function of patients in the perisurgery period and investigated the correlation between them and the prognosis of patients.

MATERIALS AND METHODS

Patients with malignant intracranial tumors admitted to Peking Union Medical College Hospital from May 2018 to August 2020 for surgery were included. The evaluations were performed 6 times in the perisurgery period. The questionnaires for assessment included QLQ-C30, ADL, and so forth.

RESULTS

A total of 165 patients were included (115 glioma and 50 brain metastases). Patients had their worst performance at the 7-day postsurgical assessment (EORTC QLQ-C30, ADL, HAD-D, Frail Scale, MMSE, MoCA, CSHA-FI, and NANO) and recovered at the 1-month postsurgical assessment (p < .05). Patients with left-sided tumors had significantly worse cognitive function than patients with right-sided tumors before surgery and at 7 days, 1 month, and 6 months after surgery (p < .05). The scores of QLQ-C30 and QLQ-BN20 at 1 month, 3 months, 6 months, and 1 year after surgery were used to reflect the prognosis, and the preoperative MoCA, NANO, CCI, CSHA-FI, and HAD score might predict the quality of life and nutrition status after operation.

CONCLUSION

The quality of life and daily living ability of patients with malignant intracranial tumors decreased significantly 7 days after the surgery but recovered 1 month after the surgery. Patients with left hemisphere lesions had a worse cognitive function, while the ADL is associated with short-term prognosis. The comprehensive evaluation of the perisurgical period can indicate the prognosis of patients and further guide clinical decision-making.

摘要

简介

颅内恶性肿瘤患者的预后情况各不相同。我们关注围手术期患者的生活质量、日常生活能力和认知功能,并研究它们与患者预后之间的相关性。

材料与方法

选取 2018 年 5 月至 2020 年 8 月期间在北京协和医院接受手术治疗的颅内恶性肿瘤患者,共 165 例(115 例胶质瘤,50 例脑转移瘤)。围手术期共进行 6 次评估,评估量表包括 EORTC QLQ-C30、ADL 等。

结果

术后第 7 天患者的各项评分(EORTC QLQ-C30、ADL、HAD-D、Frail Scale、MMSE、MoCA、CSHA-FI、NANO)最差,术后 1 个月开始恢复(p<0.05)。术前及术后第 7 天、1 个月、6 个月左侧肿瘤患者的认知功能明显差于右侧肿瘤患者(p<0.05)。术后 1 个月、3 个月、6 个月、1 年时的 QLQ-C30 和 QLQ-BN20 评分可反映患者的预后情况,术前的 MMSE、NANO、CCI、CSHA-FI、HAD 评分可能预测术后的生活质量和营养状态。

结论

颅内恶性肿瘤患者术后 7 天生活质量和日常生活能力明显下降,术后 1 个月开始恢复。左侧病变患者的认知功能更差,而 ADL 与短期预后相关。围手术期的综合评估可以预测患者的预后情况,进一步指导临床决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ccd/8613416/e6b01a7a2712/BRB3-11-e02192-g003.jpg

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