Quality of Life After Brainstem Cavernoma Surgery in 71 Patients
Quality of Life After Brainstem Cavernoma Surgery in 71 Patients
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DOI：
10.1227/neu.0b013e31821d31b7
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发表时间：
2011-09-01
期刊：
影响因子：
4.8
通讯作者：
Bertalanffy, Helmut
中科院分区：
文献类型：
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作者：
Dukatz, Thomas;Sarnthein, Johannes;Bertalanffy, Helmut
背景：有症状的脑干海绵状瘤患者接受手术治疗的频率越来越高。一般来说，患者从这种困难的手术干预中获益是通过评估神经系统症状来量化的。目的：通过评估术后生活质量（QoL），在更大的患者群体中记录手术的有益效果。方法：采用Patzold评分法和Karnofsky功能状态量表对71例手术患者进行详细的神经系统状态评估。患者用36健康问卷对生活质量进行评分。为了记录手术对生活质量的影响，我们设计了一份补充问卷。最后24例患者术前、术后均完成36项健康调查问卷。结果：71例手术患者中有44例（62%）Karnofsky表现状态量表改善，19例（27%）保持不变，8例（11%）恶化。Patzold Rating显示了更详细的神经症状。它与Karnofsky表现状态量表显著相关，这强调了它对脑干病变患者的有用性。在简表36健康调查得分中，心理成分总结在手术后得到改善（配对检验，P = 0.015）。此外，58人（82%）声称手术有明显的主观益处。结论：这个大型系列的结果支持这样一种观点，即在经验丰富的患者中，显微手术切除脑干海绵状瘤是一种有效的治疗方法，通常与良好的临床结果相关，无论是神经学还是生活质量。
BACKGROUND: Symptomatic patients with a brainstem cavernoma are treated surgically with increasing frequency. Generally, the patient's benefit from this difficult surgical intervention is quantified by the assessment of neurological symptoms.OBJECTIVE: To document the beneficial effect of surgery in a larger patient population by assessing the postoperative quality of life (QoL).METHODS: In a series of 71 surgically treated patients, a detailed neurological status was assessed by Patzold Rating and Karnofsky Performance Status Scale. Patients rated their QoL with the Short Form 36 Health Survey. To document the effect of surgery on QoL, we devised a supplementary questionnaire. The last 24 patients completed Short Form 36 Health Survey pre- and postoperatively.RESULTS: Karnofsky Performance Status Scale improved in 44 of 71 surgical patients (62%), remained unchanged in 19 (27%), and deteriorated in 8 (11%) individuals. Patzold Rating showed a more detailed picture of the neurological symptoms. It correlated significantly with Karnofsky Performance Status Scale, which underscores its usefulness for patients with brainstem lesions. In the Short Form 36 Health Survey score, the Mental Component Summary improved with surgery (paired test, P = .015). In addition, 58 individuals (82%) declared a clear subjective benefit of surgery.CONCLUSION: The results of this large series support the notion that microsurgical removal of a brainstem cavernoma represents an effective therapy in experienced hands and is generally associated with good clinical outcome, both neurologically and in terms of QoL.