Zhao Rui, Lu Pengwei, Fan Yanzhu, Li Chuzhong, Liu Chunhui, Zhao Peng, Cao Lei, Gao Hongwei, Gui Songbai
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
Front Neurol. 2021 Nov 17;12:754349. doi: 10.3389/fneur.2021.754349. eCollection 2021.
To analyze the risk factors relative to postoperative psychiatric disorders in adult patients with craniopharyngioma. A retrospective case-control study design was used in this study. The Neuropsychiatric Inventory-Questionnaire (NPI-Q) assessment tool was used to assess psychiatric disorders in postoperative patients with craniopharyngioma at Beijing Tiantan Hospital from January 2018 to December 2020. The relationship between the psychiatric disorders and basic demographic data as well as several risk factors, such as the tumor characteristics (tumor location, tumor size, pathological finding of the tumor, etc.) and treatment-related factors (the extent of the resection), were analyzed. A total of 173 patients were included in this study. The prevalence of psychiatric disorders was 14.5% among adult craniopharyngioma patients. Irritability represented the most common type of psychological symptom (64%, = 16), followed by agitation (36%, = 9), and delusions (28%, = 7). The risk factors relative to postoperative psychiatric disorders that were identified were a tumor volume larger than 7 cm (HR = 3.292, = 0.042), tumor location ( = 0.003), hypothalamic invasion (HR = 9.766, = 0.036), and gross-total resection (HR = 0.085, = 0.042). Neurocognitive assessment and intervention before and after surgery are important in patients with larger tumors, invading the third ventricle, and tumors with hypothalamic invasion. Prediction of these risk factors is essential for the treatment.
分析成年颅咽管瘤患者术后精神障碍的相关危险因素。本研究采用回顾性病例对照研究设计。使用神经精神科问卷（NPI-Q）评估工具，对2018年1月至2020年12月在北京天坛医院接受手术的颅咽管瘤患者的精神障碍进行评估。分析精神障碍与基本人口统计学数据以及几个危险因素之间的关系，这些危险因素包括肿瘤特征（肿瘤位置、肿瘤大小、肿瘤病理结果等）和治疗相关因素（切除范围）。本研究共纳入173例患者。成年颅咽管瘤患者精神障碍的患病率为14.5%。易激惹是最常见的心理症状类型（64%，n = 16），其次是激动（36%，n = 9）和妄想（28%，n = 7）。确定的与术后精神障碍相关的危险因素包括肿瘤体积大于7 cm（HR = 3.292，P = 0.042）、肿瘤位置（P = 0.003）、下丘脑侵犯（HR = 9.766，P = 0.036）和全切除（HR = 0.085，P = 0.042）。对于肿瘤较大、侵犯第三脑室以及伴有下丘脑侵犯的患者，手术前后的神经认知评估和干预很重要。对这些危险因素进行预测对治疗至关重要。
