目的:分析垂体腺瘤患者术后的生活质量,探讨影响其预后的因素。方法:于2002—01/2003-04选择华中科技大学同济医学院附属同济医院神经外科行经蝶手术的垂体瘤患者100例进行Karnofsky评分量表结合自评问卷调查。①采用Kamofsky表现评分量表评定脑肿瘤患者生活质量,主要测定患者的执行能力和进行正常活动的能力,最高为100分,最低为0分。于治疗前和治疗后1年分别评定1次。②采用自制的生活质量综合评定问卷进行生活质量自我评定,内容包括患者一般情况、疾病的症状、躯体健康、对疾病的了解程度及信心、与家人及周围人的关系、胜任劳动及家务情况、从事社会活动情况等方面。由患者根据自己的实际情况独立完成,于手术后1年进行评定。数据处理方法包括单因素多变量方差分析、多因素线性回归分析和t检验。结果:随访时间1年,随访率100%。①89例患者术后的Karnofsky评分量表评分均较术前有不同程度的升高。②影响患者术后生活质量的因素有:术前视力视野、头痛头晕呕吐、女性月经、肿瘤大小及切除程度、肿瘤复发与否、泌乳素/生长激素是否正常及性别、年龄、文化程度、职业。结论:经蝶手术作为功能保护性手术方式可以明显提高患者的生活质量,影响患者术后生活质量的根本性因素是术前状况。Karnofsky表现评分量表评分在一定程度上可以反映患者的生活质量。
AIM: To analyze the postoperative quality of life (QOL) in patients with pituitary adenomas, and investigate the factors that affect the prognosis. METHODS: Totally 1130 patients with pituitary adenomas, who were treated with transsphenoidal resection in the Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between January 2002 and April 2003, were investigated with Karnofsky performance scale (KPS) and self-rating questionnaire. ① The KPS was used to assess the QOL of patients with brain tumor mainly including the abilities of performance and normal activity, the highest and lowest scores were 100 and 0 respectively, they were assessed before treatment and at 1 year after treatment respectively.② The self-designed QOL comprehensive rating questionnaire was applied in the QOL self- evaluation, the contents included the general information, symptoms of disease, physical health, understanding and confidence to the disease, correlation with family members and people around, involvement in labor and housework, participation in social activities, etc. The questionnaires were finished by the patients according to their own actual conditions at 1 year postoperatively, The data were treated with univariate and multivariate analysis of variance, multiple linear regression analysis and t RESULTS: The patients were followed up for 1 year, and the follow-up rate was 100%. ① The postoperative KPS scores in the 89 patients were all increased to different degree as compared with the preoperative ones. ② The factors that affected the postoperative QOL of the patients were the sight before operation, headache, dizziness and vomiting, menorrhea in females, the size of the tumor, the extent of the resection, whether with recurrence or not, level of prolactin or growth hormone, gender, age, level of education and occupation. CONCLUSION: As a functional protective operation, transsphenoidal resection of pituitary adenomas can improve the QOL of t