颅咽管瘤术后下丘脑MR影像学损伤程度与并发症及预后的相关性研究

Study on the Correlation between the Extent of Hypothalamic Damage Onmr Imaging and Complications and Prognosis after Craniopharyngioma

摘要: 目的：依据下丘脑损伤Puget分级评估颅咽管瘤患者术后下丘脑受累程度，分析其与预后及相关并发症之间的相关性，探讨下丘脑损伤Puget分级用于评估颅咽管瘤患者预后转归方面的价值。方法：收集青岛大学附属医院神经外科89例颅咽管瘤患者资料，回顾性分析颅咽管瘤患者术后下丘脑MR影像损伤程度与术后并发症及预后之间的相关性。结果：下丘脑损伤Puget分级与颅咽管瘤患者预后及持续性尿崩症之间存在明显相关性(P < 0.05)，Puget 2级的患者与0级、1级患者相比预后较差，术后持续性尿崩症的患病率更高(P < 0.001)；但Puget 0级与1级患者之间在预后及持续性尿崩症患病率方面无统计学差异(P > 0.05)，Puget分级与术后下丘脑肥胖患病率之间无明显关联性(P > 0.05)。结论：下丘脑损伤Puget分级用于评估颅咽管瘤患者预后具有指导意义，Puget 2级患者与0级与1级患者相比预后较差，且具有较高的持续性尿崩症患病率。

Abstract: Objective: The degree of postoperative hypothalamic involvement in patients with craniopharyngioma was evaluated according to PUGET rating for hypothalamic injury, and the correlation between PUGET rating and prognosis and related complications was analyzed. The value of PUGET rating for evaluating the prognosis of patients with craniopharyngioma was discussed. Method: The data of 89 patients with craniopharyngioma from the Department of Neurosurgery of the Affiliated Hospital of Qingdao University were collected, and the correlation between postoperative hypothalamic damage on MR imaging, postoperative complications and prognosis in patients with craniopharyngioma was retrospectively analyzed. Results: There was a significant correlation between PUGET grade of hypothalamic injury and prognosis and persistent diabetes insipidus in patients with craniopharyngioma (P < 0.05). Patients with PUGET grade 2 had a worse prognosis and a higher prevalence of persistent diabetes insipidus after surgery than patients with grade 0 or 1 (P < 0.001). However, there was no significant difference in prognosis and prevalence of persistent diabetes insipidus between PUGET grade 0 and grade 1 patients (P > 0.05). There was no significant correlation between PUGET rating and morbidity of hypothalamic obesity (P > 0.05). Conclusion: PUGET grading is of guiding significance in evaluating the prognosis of patients with hypothalamic injury. PUGET grade 2 patients have a poorer prognosis than those in grade 0 or 1 patients, and have a higher prevalence of persistent diabetes insipidus.