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神经外科术中唤醒麻醉对患者术后神经心理功能的影响 预览 被引量:7

The influence of awake craniotomy on postoperative neuropsychology
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摘要 目的评价神经外科术中唤醒麻醉患者术后神经心理功能与生活质量。方法回顾调查81例于唤醒麻醉条件下行脑胶质瘤切除术且随访资料完整患者的临床资料,依据年龄、性别、文化程度、肿瘤位置和特征,以1:1配对选择同期于非唤醒麻醉状态下行脑胶质瘤切除术患者作为对照组,通过电话随访了解患者术后神经功能及心理状况,采用36条目简明健康调查表评价患者生活质量。结果完成全部调查研究的唤醒麻醉组和非唤醒麻醉组患者各73例,唤醒麻醉组21例存在术后神经功能缺损症状与体征,12例术后出现心理异常,30例存在术中知晓;而非唤醒麻醉组患者28例术后出现神经功能缺损,8例存在心理异常,无一例患者存在术中知晓。唤醒麻醉组术后远期(〉6个月)神经功能评价仅9例仍存在神经功能缺损症状与体征,少于非唤醒麻醉组的18例(P=0.038);术后初期、中期和远期神经功能评价,两组患者生活质量评分差异无统计学意义(均P〉0.05)。结论神经外科术中唤醒麻醉脑胶质瘤切除术是切除位于或邻近脑功能区肿瘤的主要手术方式,可以减少术后远期神经功能缺损发生率,适当的麻醉管理不会造成患者创伤后心理障碍,亦不影响其术后生活质量。 Objective To assess the neuropsychological function and quality of life of the patients after awake craniotomy (AC). Methods A case-control study was conducted among 81 patients who underwent awake craniotomy, and a 1-to-1 control group (matched by age, gender, degree of education, tumor location and characteristic) undergoing general anesthesia (GA) in glioma resections was assembled. The incidence of postoperative neurological deficits, psychological disorders and recurrence were investigated during telephone follow-ups, and Medical Outcomes Study Short Form 36 (SF-36) was adopted to evaluate the life quality of patients. Results Almost 73 pairs of patients fulfilled the survey of AC and GA group respectively. There were 21 patients and 28 patients with postoperative neurological deficits, and 12 patients and 8 patients with psychological disorders in AC and GA group respectively. Thirty patients of AC group had the recollection of being awake during the surgery. There were 9 patients in CA group having long-term ( 〉 6 months) neurological deficits, which was less than the number of GA group (18 patients, P = 0.038). According to the assessment in short-term, medium-term and long-term postoperative neurological deficits, there was no significant difference in the quality-of-life scores between the two groups (P 〉 0.05, for all). Conclusion Awake craniotomy can be the main method for removing the lesions located in or close to functional areas with lower incidence of long-term postoperative neurological deficits, and it has no significant impact on the psychological status and the quality of life postoperatively.
作者 杨明媛 耿莹 王刚 韩如泉 YANG Ming-yuan, GENG Ying, WANG Gang, HAN Ru-quan(1.Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beifing 100050, China 2Department of Depression Treatment Center, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China)
出处 《中国现代神经疾病杂志》 CAS 2012年第6期701-706,共6页 Chinese Journal of Contemporary Neurology and Neurosurgery
基金 基金项目:北京市卫生系统高层次技术人才资助项目(项目编号:2009-3-19)
关键词 麻醉 静脉 清醒镇静 神经胶质瘤 神经心理学测验 神经外科手术 手术后并发症 Anesthesia, intravenous Conscious sedation Glioma Neuropsychological tests Neurosurgical procedures Postoperative complications
作者简介 通讯作者:韩如泉(Email:hanrq666@yahoo.com.cn)
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参考文献22

  • 1Bonhommea V, Franssenb C, Hans P. Awake craniotomy. Eur J Anaesthesiol, 2009, 26:906-912. 被引量:1
  • 2Kim SS, McCutcheon IE, Suki D, et al. Awake craniotomy for brain tumors near eloquent cortex: correlation of intraoperative cortical mapping with neurological outcomes in 309 consecutive patients. Neurosurgery, 2009, 64:836-845. 被引量:1
  • 3Sanai N, Berger MS. Glioma extent of resection and its impact on patient outcome. Neurosurgery, 2008, 62:753-766. 被引量:1
  • 4Ware JE, Snow KK, Kosinski M, et al. SF-36 heahh survey: manual and interpretation guide. 2nd ed. Boston: The Health Institute, New England Medical Center, 1993:1-12. 被引量:1
  • 5韩如泉.神经外科麻醉:现状与展望[J].中国现代神经疾病杂志,2010(4):400-401. 被引量:14
  • 6韩如泉,程灏,王德祥.神经外科术中唤醒麻醉现状[J].中国现代神经疾病杂志,2010(4):406-411. 被引量:10
  • 7Sacko O, Lauwers- Cances V, Brauge D, et al. Awake craniotomy versus surgery under general anesthesia for resection of supratentorial lesions. Neurosurgery, 2011, 68:1192- 1199. 被引量:1
  • 8Boulton M, Bernstein M. Outpatient brain tumor surgery: innovation in surgical neurooncology. J Neurosurg, 2008, 108: 649-654. 被引量:1
  • 9Serletis D, Bernstein M. Prospective study of awake craniotomy used routinely and nonselectively for supratentorial tumors. J Neurosurg, 2007, 107:1-6. 被引量:1
  • 10Danks RA, Aglio LS, Gugino LD, et al. Craniotomy under local anesthesia and monitored conscious sedation for the resection of tumors involving eloquent cortex. J Neurooncol, 2000, 49:131- 139. 被引量:1

二级参考文献137

  • 1李秀钧,董砚虎,程丽霞,柳林.糖尿病研究进展——第16届国际糖尿病联盟大会纪要[J].中华内分泌代谢杂志,1998,14(2):72-77. 被引量:153
  • 2李广宇 ,刘立军 ,孙德荣 ,方向丽 ,路玉兰 .廊坊师范学院大学生生命质量影响因素分析[J].中国学校卫生,2004,25(6):651-652. 被引量:8
  • 3李家才,李成兵,查梅,梁鸿华,石武祥(指导教师).大理学院大学生生命质量的调查分析[J].大理学院学报:综合版,2006,5(10):80-82. 被引量:16
  • 4[2]Ware JE.SF-36 Health Survehy.Mannual and Interpretation Guide[M].Boston.MA:The Health.Institute,1993. 被引量:1
  • 5[6]Hanetak B R. Quality of life and Insulin-dependent diabetes mellitus. Department of Public Health Care Division for Nursing Science [M] . University of Bergen, 1992. 1-33. 被引量:1
  • 6Jaaskelainen J, Randell T. Awake craniotomy in glioma surgery. Acta Neuroehir Suppl, 2003, 88:31-35. 被引量:1
  • 7Meyer FB, Bates LM, Goerss SJ, et al. Awake craniotomy for aggressive resection of primary gliomas located in eloquent brain. Mayo Clin Proc, 2001, 76:677-687. 被引量:1
  • 8Lanier WL. Brain tumor resection in the awake patient. Mayo Clin Proc, 2001, 76:670-672. 被引量:1
  • 9Picht T, Kombos T, Gramm H J, et al. Multimodal protocol for awake craniotomy in language cortex tumour surgery. Acta Neurochir (Wien), 2006, 148:127-138. 被引量:1
  • 10Shinoura N, Yamada R, Kodama T, et al. Preoperative fMRI, traetography and continuous task during awake surgery for maintenance of motor function following surgical resection of metastatic tumor spread to the primary motor area. Minim Invasive Neurosurg, 2005.48:85-90. 被引量:1

共引文献191

同被引文献61

  • 1Ricard D, Idbaih A, Ducray F, et al. Primary brain turnouts in adults[J]. Lancet, 2012, 379(9830):1984-1996. 被引量:1
  • 2Elsherbiny ME, Emara M, Godbout R. Interaction of brain fatty acid-binding protein with the polyunsaturated fatty acid environment as a potential determinant of poor prognosis in malignant glioma[J]. Prog Lipid Res, 2013, 52(4) :562-570. 被引量:1
  • 3董晓书,王翔,毛庆.成人幕上低级别胶质瘤患者术后生活质量相关因素评估[G].中国医师协会神经外科医师分会-第六届全国代表大会论文汇编,2011. 被引量:1
  • 4Porter KR, Menon U, Vick NA, et al. Assessment of clinical and nonclinical characteristics associated with health-related quality of lfie in patients with high-grade gliomas: a feasibility study [ J ]. Support Care Cancer, 2014, 22 (5) : 1349-1362. 被引量:1
  • 5Pouratian N, Schiff D. Management of low-grade glioma L J J. Curr Neurol Neurosei Rep, 2010, 10(3) : 224-231. 被引量:1
  • 6Boele FW, Zant M, Heine EC, et al. The association between cognitive functioning and health-related quality of life in low-grade glioma patients [ J ]. Neurooneol Pract, 2014, 1 (2) : 40-46. 被引量:1
  • 7Goebel S, Stark AM, Kaup L, et al. Distress in patients with newly diagnosed brain turnouts [J]. Psychooncology, 2011, 20 (6) : 623-630. 被引量:1
  • 8Rooney AG, Carson A, Grant R. Depression in cerebral glioma patients: a systematic review of observational studies[ J]. J Natl Cancer Inst,2011,103(1) : 61-76. 被引量:1
  • 9Rooney AG, Carson A, Grant R. Depression in cerebral glioma patients: a systematic review of observational studies [ J ]. J Natl Cancer Inst, 2011, 103(1) : 61-76. 被引量:1
  • 10Rooney AG, Mcnamara S, Mackinnon M, et al. Frequency, clinical associations, and longitudinal course of major depressive disorder in adults with cerebral glioma[J]. J Clin Oncol, 2011, 29(32) : 4307-4312. 被引量:1

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