以癫癎为首发症状的低级别星形细胞瘤病人术后癫癎预后分析

目的探讨影响以癫癎为首发症状的低级别星形细胞瘤癫癎预后的因素。方法回顾性分析以癫癎为首发症状的低级别星形细胞瘤病例，经手术切除肿瘤1年后的癫癎症状改善情况，本组研究数据应用SPSS17．0统计软件进行卡方检验和多因素Logistic回归分析。结果术后癫癎预后为改良Engel I级102例（67．5％），Ⅱ级以上49例（32．5％）。卡方检验显示：术前病人有语言障碍（P=0．038）、术前肿瘤累及岛叶（P=0．010）、肿瘤未全切除（P=0．001）对术后癫癎预后差异有统计学意义。多因素Logistic回归分析：术前病人有语言障碍（P=0．022）、术前肿瘤累及岛叶（P=0．007）及肿瘤未全切除（P=0．002）均为影响术后癫癎发作的独立危险因素。结论术前病人有语言障碍、术前肿瘤累及岛叶及肿瘤未全切除是影响以癫癎为首发症状的低级别星形细胞瘤病人术后癫癎预后的独立危险因素。

Prognostic analysis of postoperative seizure in low-grade astrocytomas patients with seizures as initial symptom

Objective To explore prognosis factors of postoperative seizure in low-grade astrocytoma patients with seizures as initial symptom. Methods The seizure outcomes one year after tumor removal in low-grade astrocytoma patients with seizures as initial symptom were analyzed retrospectively. The analyses were performed by the SPSS 17.0 software using chi-square test and multivariate logistic regression method. Results According to Engel classification, the postoperative seizure outcomes were grade I in 102 cases （67.5%）, above grade 11 in 49 （32.5%）. The chi-square test showed that preoperative language deficit （P = 0.038）, preoperative tumor involving the insular lobe （P = 0.010）, subtotal resection of tumor （P = 0.001） were associated with postoperative seizure outcomes. The multivariate logistic regression analysis also showed that preoperative language deficit （P = 0.022）, preoperative tumor involving the insular lobe （P = 0.007） and subtotal resection of tumor （P = 0.002） were significantly associated with postoperative seizure outcomes. Conclusion Preoperative language deficit, preoperative tumor involving the insular lobe and subtotal resection of tumor are three independent risk factors of postoperative seizure outcomes in low-grade astrocytoma patients with seizures as initial symptom.