摘要
目的 通过收集听神经瘤患者术前前庭功能检查及术后早期前庭症状表现,探究听神经瘤患者术后早期前庭功能特点及相关影响因素.方法 研究纳入64例在2021年2月—2022年2月期间接受肿瘤切除治疗的单侧听神经瘤患者.分别于术后1d、3d、7d、30 d记录患者前庭症状类型,并使用前庭症状相关视觉模拟量表(VAS-V)对前庭症状的严重程度进行评价.根据术后30 d VAS-V评分中位数(VAS-V评分中位数=2)将患者分为前庭症状缓解组(VAS-V≤2)和前庭症状存续组(VAS-V＞2).比较2组患者的人口学信息、Koos分级、术前前庭功能检查结果的差异;构建二元logistic回归模型探索术后早期前庭症状存续的影响因素.结果 听神经瘤术后第3天前庭症状表现最明显;术后7～30d,没有明显变化;术后30 d以头晕和姿势不稳为主,分别有33例(51.6％)和31例(48.4％).二元logistics回归分析显示,视频头脉冲试验(vHIT)增益正常(OR=4.06,P=0.039)、冷热试验单侧减弱(UW)＜75％(OR=12.45,P=0.001)、女性(OR=0.22,P=0.038)是术后30 d前庭症状存续的独立风险因素.结论 术前前庭功能、性别是预测听神经瘤患者术后前庭症状的重要因素,且术前前庭功能损伤程度与术后前庭症状存续时间呈负相关,有助于为听神经瘤患者术后早期前庭功能恢复情况提供参考.
Abstract
Objective To explore the clinical characteristics and influencing factors of early postoperative vestibular symptoms in patients with acoustic neuroma by collecting preoperative vestibular function examination,clinical data,and early postoperative vestibular symptom data.Methods The study included 64 patients who had undergone surgery for acoustic neuroma between February 2021 and February 2022.Vestibular symptom types were recorded postoperative 1 day,3 days,7 days,30 days respectively,and the severity of vestibular symptoms were assessed using visual analogue scale for vestibular symptoms(VAS-V).Patients were divided into the vestibular symptom relief group(VAS-V≤2)and the vestibular symptom persistence group(VAS-V＞2)based on the median VAS-V score at 30 days postoperatively(VAS-V median score=2).Differences in demographic information,Koos grade,and preoperative vestibular examination results were compared between the two groups.A binary logistic regression model was constructed to explore the influencing factors for the persistence of early postoperative vestibular symptoms.Results Vestibular symptoms were most pronounced on postoperative day 3,and there was no significant change in vestibular symptoms from postoperative day 7 to day 30.The most common vestibular symptoms 30 days after the surgery were dizziness and postural symptoms,in 33 cases(51.6％)and 31 cases(48.4％),respectively.Binary logistic regression analysis showed that normal video-head impulse test(vHIT)gain(OR=4.06,P=0.039),cold calorics test unilateral weekness(UW)＜75％(OR=12.45,P=0.001),and gender(OR=0.22,P=0.038)were independent risk factors for the persistence of vestibular symptoms at 30 days postoperatively.Conclusions Preoperative vestibular function and gender are important factors in predicting postoperative vestibular symptoms in patients with acoustic neuroma,and the degree of preoperative vestibular function injury is negatively correlated with the duration of postoperative vestibular symptoms,which is helpful to providing references for early postoperative vestibular function recovery in patients with acoustic neuroma.
维普
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