脑肿瘤切除术后患者下尿路功能障碍与功能预后的关系。

Ga Ram Hong, Min Ho Chun
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摘要

本研究旨在比较脑肿瘤手术患者康复后与初始尿潴留(UR)程度的功能结局。回顾性分析2011年1月至2021年12月转入单中心康复医学科的61例患者的病历。患者资料包括空后残留尿(PVR)、肿瘤特征和功能状态。采用简易精神状态检查(MMSE)、修正Barthel指数(MBI)、功能活动分类(FAC)、修正Rankin量表(mRS)、下肢运动指数(MI)和Berg平衡量表(BBS)评估功能状态。在标准住院康复后3周重新评估MMSE、FAC、mRS和下肢mi。尿路组24例,非尿路组37例。UR组患者初始MMSE、MBI、BBS、FAC、mRS均明显变差,康复后两组功能均有明显改善。康复后,UR组MMSE、FAC、MRS、MI-lower仍较差,但组间改善程度无显著差异。康复治疗对脑肿瘤患者是有效的,与UR无关。脑肿瘤术后初始UR与康复早期及康复后功能状态不良均有显著相关性。
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Relation between Lower Urinary Tract Dysfunction and Functional Outcome in Patients After Brain Tumor Resection.

This study aimed to compare functional outcomes after rehabilitation with initial degree of urinary retention (UR) in patients operated on for brain tumors. Medical records of 61 patients transferred to the Department of Rehabilitation Medicine of single center, from January 2011 to December 2021, were reviewed retrospectively. Patient data included post-void residual (PVR) urine, tumor characteristics, and functional status. Functional status was evaluated on the Mini-Mental Status Examination (MMSE), Modified Barthel Index (MBI), Functional Ambulation Category (FAC), Modified Rankin Scale (mRS), Motricity Index (MI)-lower limb, and Berg Balance Scale (BBS). MMSE, FAC, mRS, and MI-lower limb were re-evaluated 3 weeks after standard inpatient rehabilitation. Twenty-four patients were in the UR group and 37 in the non-UR group. Initial MMSE, MBI, BBS, FAC, and mRS were significantly worse in the UR group, and both groups showed significant functional improvement after rehabilitation. After rehabilitation, MMSE, FAC, MRS, MI-lower were still worse in the UR group, but the degree of improvement between the groups was not significantly different. Rehabilitation was shown to be effective for brain tumor patients regardless of UR. Initial UR after brain tumor surgery is significantly associated with poor functional status in both the early stages of rehabilitation and after rehabilitation.

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