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采用显微手术治疗颅底脑膜瘤患者的生活质量:一项前瞻性观察研究。

Quality of life in patients with skull base meningiomas treated with microsurgery: a prospective observational study.

机构信息

Department of Neurosurgery & Gamma Knife Surgery, P D Hinduja National Hospital & Medical Research Centre, Veer Savarkar Marg, Mumbai, India.

Department of Neurosurgery, Medical University of Vienna, Vienna, Austria.

出版信息

Acta Neurochir (Wien). 2024 Oct 19;166(1):416. doi: 10.1007/s00701-024-06291-9.

Abstract

BACKGROUND

Skull base meningiomas are chronic conditions that can present with a wide variety of symptoms ranging from near normalcy to chronic and prolonged disability and also often worsen by treatment-related sequelae. Hence, it is necessary to investigate the quality of life (QOL) among patients with skull base meningioma and evaluate the impact of microsurgery on their overall well-being.

METHODS

In this prospective observational study, 36 patients undergoing microsurgery for skull base meningioma were assessed for QOL using SF-36 questionnaires. Results were compared to the QOL of 36 patients with a non-neurosurgical chronic disease (diabetes mellitus) and 36 matched healthy volunteers. This study commenced from 2019 and ended in 2022.

RESULTS

All QOL parameters in skull base meningioma patients were preoperatively significantly worse than in the healthy population. The most affected QOL domain were role limitation due to physical health (RLPH) and role limitation due to emotional problems (RLEP). Within one year after surgery, skull base meningioma patients showed a significant improvement of all QOL parameters. The domains of physical functioning (PF), emotional well-being (EWB), body pain (BP) and general health (GH) improved to similar values as their matched healthy controls. However, social functioning (SF), RLPH, and RLPE remained still significantly affected. Compared to chronic diabetic patients, the domains PF, EWB, BP, and GH showed significantly better QOL values after one year in skull base meningioma patients, but RLEP and RLPH were worse.

CONCLUSION

Microsurgery can significantly improve all QOL domains in skull base meningioma patients within one year. Physical activity, overall health, and mental well-being have been observed to return to even normal levels. While certain QOL domains may still be affected post-microsurgery, it is evident that microsurgery can yield a substantial improvement, ultimately raising QOL to levels surpassing those seen in other non-neurosurgical chronic diseases, such as diabetes mellitus.

摘要

背景

颅底脑膜瘤是一种慢性疾病,其症状多种多样,从接近正常到慢性和长期残疾,并且常常因治疗相关的后遗症而加重。因此,有必要调查颅底脑膜瘤患者的生活质量(QOL),并评估显微镜手术对其整体健康的影响。

方法

在这项前瞻性观察研究中,使用 SF-36 问卷评估了 36 例接受颅底脑膜瘤显微镜手术的患者的 QOL。结果与 36 例非神经外科慢性疾病(糖尿病)患者和 36 例匹配的健康志愿者的 QOL 进行了比较。本研究于 2019 年开始,2022 年结束。

结果

颅底脑膜瘤患者的所有 QOL 指标在术前均明显差于健康人群。受影响最严重的 QOL 领域是因身体原因导致的角色受限(RLPH)和因情绪问题导致的角色受限(RLEP)。在手术后一年内,颅底脑膜瘤患者的所有 QOL 指标均显著改善。身体功能(PF)、情感健康(EWB)、身体疼痛(BP)和一般健康(GH)等领域的改善值与匹配的健康对照组相似。然而,社会功能(SF)、RLPH 和 RLEP 仍然受到显著影响。与慢性糖尿病患者相比,颅底脑膜瘤患者在手术后一年时,PF、EWB、BP 和 GH 等领域的 QOL 值明显更好,但 RLEP 和 RLPH 更差。

结论

显微镜手术可在一年内显著改善颅底脑膜瘤患者的所有 QOL 领域。体力活动、整体健康和心理健康已观察到恢复到甚至正常水平。尽管手术后某些 QOL 领域仍可能受到影响,但显微镜手术可以显著改善 QOL,最终使 QOL 提高到超过其他非神经外科慢性疾病(如糖尿病)的水平。

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