小脑缄默综合征儿童幸存者术后的长期生活质量
Long-term postoperative quality of life in childhood survivors with cerebellar mutism syndrome.
作者信息
Zhu Kaiyi, Yang Wei, Ying Zesheng, Cai Yingjie, Peng XiaoJiao, Zhang Nijia, Sun Hailang, Ji Yuanqi, Ge Ming
机构信息
Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China.
Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Front Psychol. 2023 Feb 24;14:1130331. doi: 10.3389/fpsyg.2023.1130331. eCollection 2023.
BACKGROUND
To investigate the long-term quality of life (QoL) of children with cerebellar mutism syndrome (CMS) and explore the risk factors for a low QoL.
PROCEDURE
This cross-sectional study investigated children who underwent posterior fossa surgery using an online Pediatric Quality of Life Inventory questionnaire. CMS and non-CMS patients were included to identify QoL predictors.
RESULTS
Sixty-nine patients were included (male, 62.3%), 22 of whom had CMS. The mean follow-up time was 45.2 months. Children with CMS had a significantly lower mean QoL score (65.3 vs. 83.7, < 0.001) and subdomain mean scores (physical; 57.8 vs. 85.3, < 0.001; social: 69.5 vs. 85.1, = 0.001; academic: = 0.001) than those without CMS, except for the emotional domain (78.0 vs. 83.7, = 0.062). Multivariable analysis revealed that CMS (coefficient = -14.748.61, = 0.043), chemotherapy (coefficient = -7.629.82, = 0.013), ventriculoperitoneal (VP) shunt placement (coefficient = -10.14, = 0.024), and older age at surgery (coefficient = -1.1830, = 0.007) were independent predictors of low total QoL scores. Physical scores were independently associated with CMS (coefficient = -27.4815.31, = 0.005), VP shunt placement (coefficient = -12.86, = 0.025), and radiotherapy (coefficient = -13.62, = 0.007). Emotional score was negatively associated with age at surgery (coefficient = -1.92, = 0.0337) and chemotherapy (coefficient = -9.11, = 0.003). Social scores were negatively associated with male sex (coefficient = -13.68, = 0.001) and VP shunt placement (coefficient = -1.36, = 0.005), whereas academic scores were negatively correlated with chemotherapy (coefficient = -17.45, < 0.001) and age at surgery (coefficient = -1.92, = 0.002). Extent of resection (coefficient = 13.16, = 0.021) was a good predictor of higher academic scores.
CONCLUSION
CMS results in long-term neurological and neuropsychological deficits, negatively affecting QoL, and warranting early rehabilitation.
背景
研究小脑缄默综合征（CMS）患儿的长期生活质量（QoL），并探讨生活质量低下的危险因素。
方法
这项横断面研究使用在线儿童生活质量量表问卷对接受后颅窝手术的儿童进行了调查。纳入CMS和非CMS患者以确定生活质量的预测因素。
结果
共纳入69例患者（男性占62.3%），其中22例患有CMS。平均随访时间为45.2个月。与非CMS患儿相比，CMS患儿的平均生活质量得分显著更低（65.3对83.7，P<0.001），各子领域平均得分也更低（身体领域：57.8对85.3，P<0.001；社会领域：69.5对85.1，P=0.001；学业领域：P=0.001），情感领域除外（78.0对83.7，P=0.062）。多变量分析显示，CMS（系数=-14.74 8.61，P=0.043）、化疗（系数=-7.62 9.82，P=0.013）、脑室腹腔（VP）分流置入（系数=-10.1 <0.001）和手术时年龄较大（系数=-1.18 30，P=0.007）是总生活质量得分低的独立预测因素。身体领域得分与CMS（系数=-27.48 15.31，P=0.005）、VP分流置入（系数=-12.8 <0.001）和放疗（系数=-13.62，P=0.007）独立相关。情感领域得分与手术时年龄（系数=-1.92，P=0.0337）和化疗（系数=-9.11，P=0.003）呈负相关。社会领域得分与男性性别（系数=-13.68，P=0.001）和VP分流置入（系数=-1.36，P=0.005）呈负相关，而学业领域得分与化疗（系数=-17.45，P<0.001）和手术时年龄（系数=-1.92，P=0.002）呈负相关。切除范围（系数=13.16，P=0.021）是学业领域得分较高的良好预测因素。
结论
CMS会导致长期的神经和神经心理缺陷，对生活质量产生负面影响，需要早期康复治疗。
Zotero 插件