| 摘要: |
| ［摘要］ 目的 探讨肥胖与前庭神经鞘瘤（VS）患者术后并发症及二次手术的关联性。方法 回顾性分析2013年6月至2023年6月于新疆医科大学第一附属医院接受乙状窦后入路手术治疗的377例VS患者的临床及影像学资料。根据体质量指数（BMI）将患者分为肥胖组（BMI≥28 kg/m2，91例）和非肥胖组（BMI<28 kg/m2，286例）。比较两组临床资料及术后并发症发生率和二次手术率，采用多因素logistic回归分析探讨BMI对术后脑脊液漏及二次手术的影响。结果 与非肥胖组相比，肥胖组性别为男性，以及合并糖尿病、高血压的人数比例更大，差异有统计学意义（P<0.05）。两组年龄、住院时间、手术侧别、肿瘤性质、肿瘤体积分级、手术时间比较差异无统计学意义（P>0.05）。肥胖组术后脑脊液漏发生率及二次手术率高于非肥胖组，差异有统计学意义（P<0.05）。两组颅内出血、切口感染、颅内感染、深静脉血栓及其他术后并发症发生率比较差异无统计学意义（P>0.05）。经调整年龄、性别、肿瘤体积分级、肿瘤性质后，多因素logistic回归分析结果显示，较高的BMI水平是患者发生术后脑脊液漏［OR(95%CI)=1.168（1.051～1.299），P=0.004］及二次手术［OR(95%CI)=1.160（1.053～1.277），P=0.003］的危险因素。结论 肥胖与VS患者术后脑脊液漏和二次手术密切相关，且BMI增高是VS患者术后脑脊液漏和二次手术的危险因素。 |
| 关键词: 前庭神经鞘瘤 肥胖 术后并发症 脑脊液漏 二次手术 |
| DOI：10.3969/j.issn.1674-3806.2024.04.13 |
| 分类号:R 739.41 |
| 基金项目:新疆维吾尔自治区青年科学基金项目（编号：2022D01C758） |
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| A study on the correlation of obesity with postoperative complications and re-operation in patients with vestibular schwannoma |
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LI Wenzhuang, WANG Zening, LI Yandong, ZHU Guohua, Maidinaimu Mahemuti, Maimaitili Mijiti, Geng Dangmurenjiafu
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Department of Neurosurgery, the First Teaching Hospital of Xinjiang Medical University, Urumqi 830054, China
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| Abstract: |
| ［Abstract］ Objective To explore the correlation of obesity with postoperative complications and re-operation in patients with vestibular schwannoma(VS). Methods The clinical and imaging data of 377 patients with VS who underwent retrosigmoid approach surgery in the First Teaching Hospital of Xinjiang Medical University from June 2013 to June 2023 were retrospectively analyzed. According to body mass index(BMI), the patients were divided into obese group(BMI≥28 kg/m2, 91 cases) and non-obese group(BMI<28 kg/m2, 286 cases). The clinical data, the incidence rate of postoperative complications and the re-operation rate were compared between the two groups. The influence of BMI on postoperative cerebrospinal fluid leakage and re-operation was explored by using multivariate logistic regression analysis. Results Compared with the non-obese group, the obese group had higher proportion of male sex, patients complicated with diabetes mellitus and hypertension, and the difference was statistically significant(P<0.05). There were no significant differences in age, hospitalization time, operation side, tumor nature, tumor volume grade and operation time between the two groups(P>0.05). The incidence rate of postoperative cerebrospinal fluid leakage and the re-operation rate in the obese group were higher than those in the non-obese group, and the differences were statistically significant(P<0.05). There were no significant differences in the incidence rates of intracranial hemorrhage, incision infection, intracranial infection, deep vein thrombosis and other postoperative complications between the two groups(P>0.05). After adjusting for age, sex, tumor volume grade and tumor nature, the results of multivariate logistic regression analysis showed that higher BMI level was a risk factor for postoperative cerebrospinal fluid leakage［OR(95%CI)=1.168(1.051-1.299), P=0.004］ and re-operation［OR(95%CI)=1.160(1.053-1.277), P=0.003］. Conclusion Obesity is closely related to postoperative cerebrospinal fluid leakage and re-operation in VS patients, and the increased BMI is a risk factor for postoperative cerebrospinal fluid leakage and re-operation. |
| Key words: Vestibular schwannoma(VS) Obesity Postoperative complication Cerebrospinal fluid leakage Re-operation |
