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目的探讨影响以癫为首发症状的低级别星形细胞瘤癫预后的因素。方法回顾性分析以癫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。结果术后癫预后为改良EngelⅠ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为首发症状的低级别星形细胞瘤病人术后癫预后的独立危险因素。
Objective To investigate the prognostic factors of epilepsy in low-grade astrocytomas with epilepsy as the first symptom. Methods A retrospective analysis of epilepsy as the first symptom of low-grade astrocytoma cases, surgical resection of the tumor after 1 year of epilepsy to improve the situation, the data of this study using SPSS17.0 statistical software for chi-square test and multiple factors Logistic regression analysis. Results The postoperative epilepsy prognosis was modified Engel Ⅰ grade 102 cases (67.5%), Ⅱ grade 49 cases (32.5%). Chi-square test showed that preoperative patients had speech impairment (P = 0.038), preoperative tumor involving the insula (P = 0.010), tumor incomplete resection (P = 0.001) had significant difference in the prognosis of postoperative epilepsy. Multivariate logistic regression analysis showed that preoperative patients had speech disorders (P = 0.022), preoperative tumor involvement of the insula (P = 0.007) and tumor incomplete resection (P = 0.002) were independent risk factors for postoperative epileptic seizures factor. Conclusion Preoperative patients with speech disorders, preoperative tumor involving the insula and tumor incomplete resection is the risk of epilepsy as the first symptom of low-grade astrocytoma patients postoperative epilepsy prognostic independent risk factors.