肥胖与小儿癫痫手术并发症关系的研究。

Study on the relationship between obesity and complications of Pediatric Epilepsy surgery.

机构信息

Department of Neurosurgery, Zhongnan Hospital, Wuhan University, 430071, Wuhan, Hubei, China.

Department of Neurosurgery, Wuhan Children's Hospital, 430010, Wuhan, Hubei, China.

出版信息

BMC Pediatr. 2023 Mar 30;23(1):142. doi: 10.1186/s12887-023-03948-9.

DOI:10.1186/s12887-023-03948-9

PMID:36997989

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10061988/

Abstract

OBJECTIVE

Studies have shown that obesity has a significant impact on poor surgical outcomes. However, the relationship between obesity and pediatric epilepsy surgery has not been reported. This study aimed to explore the relationship between obesity and complications of pediatric epilepsy surgery and the effect of obesity on the outcome of pediatric epilepsy surgery, and to provide a reference for weight management of children with epilepsy.

METHODS

A single-center retrospective analysis of complications in children undergoing epilepsy surgery was conducted. Body mass index (BMI) percentiles were adjusted by age and used as a criterion for assessing obesity in children. According to the adjusted BMI value, the children were divided into the obese group (n = 16) and nonobese group (n = 20). The intraoperative blood loss, operation time, and postoperative fever were compared between the two groups.

RESULTS

A total of 36 children were included in the study, including 20 girls and 16 boys. The mean age of the children was 8.0 years old, ranging from 0.8 to 16.9 years old. The mean BMI was 18.1 , ranging from 12.4 to 28.3 . Sixteen of them were overweight or obese (44.4%). Obesity was associated with higher intraoperative blood loss in children with epilepsy (p = 0.04), and there was no correlation between obesity and operation time (p = 0.21). Obese children had a greater risk of postoperative fever (56.3%) than nonobese children (55.0%), but this was statistically nonsignificant (p = 0.61). The long-term follow-up outcomes showed that 23 patients (63.9%) were seizure-free (Engel grade I), 6 patients (16.7%) had Engel grade II, and 7 patients (19.4%) had Engel grade III. There was no difference in long-term seizure control outcomes between obese and nonobese groups (p = 0.682). There were no permanent neurological complications after surgery.

CONCLUSION

Compared with nonobese children with epilepsy, obese children with epilepsy had a higher intraoperative blood loss. It is necessary to conduct early weight management of children with epilepsy as long as possible.

摘要

目的

研究表明肥胖对手术不良结局有显著影响。然而，肥胖与小儿癫痫手术之间的关系尚未得到报道。本研究旨在探讨肥胖与小儿癫痫手术并发症的关系，以及肥胖对小儿癫痫手术结果的影响，为小儿癫痫患儿的体重管理提供参考。

方法

对单中心行癫痫手术患儿的并发症进行回顾性分析。采用年龄调整的体质指数（BMI）百分位作为评估儿童肥胖的标准。根据调整后的 BMI 值，将患儿分为肥胖组（n=16）和非肥胖组（n=20）。比较两组患儿的术中出血量、手术时间和术后发热情况。

结果

本研究共纳入 36 例患儿，其中女孩 20 例，男孩 16 例。患儿平均年龄为 8.0 岁，年龄 0.8~~16.9 岁。患儿平均 BMI 为 18.1，BMI 12.4~~28.3。超重或肥胖患儿 16 例（44.4%）。肥胖与癫痫患儿术中出血量增加相关（p=0.04），与手术时间无相关性（p=0.21）。肥胖患儿术后发热风险（56.3%）高于非肥胖患儿（55.0%），但差异无统计学意义（p=0.61）。长期随访结果显示，23 例患儿（63.9%）无癫痫发作（Engel 分级Ⅰ级），6 例患儿（16.7%）为 Engel 分级Ⅱ级，7 例患儿（19.4%）为 Engel 分级Ⅲ级。肥胖组与非肥胖组患儿的长期癫痫控制效果无差异（p=0.682）。术后无永久性神经功能并发症。