| Objective: To discuss about the correlation degree between relative factors and epileptic seizure in early period of postoperative brain glioma;by means of single factor chi-squared test and multi-factor Logistic regression analysis,to find out the risk factors and protective factors of epileptic seizure in early period of postoperative brain glioma,and then propose corresponding treatment solution so as to reduce the incidence of epileptic seizure in early period of postoperative brain glioma and improve life quality.Methods: 183 patients received supra-tentorial brain glioma resection operation in The First Affiliated Hospital in Suzhou University during September 2012-December 2016 were collected to screen the independent variables,including gender(male/female),age(?14,14-59,?60),preoperative epilepsy history(yes/no),tumor size(<3cm,3-5cm,>5cm),tumor localization(frontal lobe,temporal lobe,parietal lobe,occipital lobe and others),peritumoral edema(none,< 2cm,> 2cm),operative approach(frontal lobe,temporal lobe,parietal lobe,frontal and temporal part,frontal parietal and others),post-operative tumor resection degree(total resection,subtotal resection and partial resection),bleeding in post-operative tumor cavity(none,punctuatehemorrhage,hematoma),pathology grade(Grade?-?,Grade?,Grade?),utilization of Depakine in vein after operation to prevent epilepsy(yes/no),anti-epileptic therapy after operation(yes/no);epileptic seizure was screened as dependent variable.Adopted SPSS 19.0 software,chi-square test to single factor analysis of absolute variable,t test to measurement data independent sample;logistic regression analysis was applied to multi-factor analysis to find out the risk factors and protective factors of epileptic seizure in early period of postoperative brain glioma;P<0.05 indicated that the difference was statistically significant.Results: Among the 183 patients with brain glioma in this group,18 cases got secondary epileptic seizure in early period of postoperative brain glioma with the incidence of 9.84%,among which 4 cases got general grand mal with occupying 22.22%;8 cases got partial seizure with occupying44.44%;6 cases got pure simple partial seizure with occupying 33.34%.1?The specific is as follows:(figure=cases of epileptic seizure in early period of postoperative brain glioma/ cases of patients,incidence of epileptic seizure in early period of postoperative brain glioma)Gender: Male patients 11/115,9.57%;female patients 7/68,10.29%.Age: ?14 0/1,0%;14-59 13/132,9.85%;?60 5/50,10.00%.Preoperative epilepsy history: patients with preoperative epilepsy history 10/42,23.81%;patients without preoperative epilepsy history 8/141,5.68%.Tumor size: patients with tumor size<3cm before operation 7/71,9.86%;patients with tumor size 3-5cm 8/82,9.76%;patients with tumor size>5cm 3/30,10%.Tumor localization: frontal lobe3/44,6.82%;temporal lobe6/51,11.76%;parietal lobe5/15,33.33%;occipital lobe 0/4,0%;others(forehead 2/22;parietal lobe 2/13,parietal lobe0/11,occipital lobe 0/9,parietal-occipital lobe 0/7;ventricle 0/5,0%)4/69,5.80%.Peritumoral edema: patients without edema 7/97,7.22%;patients with peripheral edema<2cm 7/52,13.46%;patients with peripheral edema >2cm 4/34,11.76%.Operative approach: frontal lobe 3/44,6.82%;temporal lobe 4/27,14.81%;parietal lobe 2/8,25.00%;frontal and temporalpart 5/46,10.87%;frontal parietal 2/17,11.76%;others(occiput 0/3;frontotemporal and parietal 1/17;temporal occipitoparietal1/12;parietal-occipital 0/6;ventricle 0/3)2/41,4.88%.Tumor resection degree: total resection8/151,5.30%;subtotal resection 6/23,26.09%;partial rese-ction 4/9,44.44%.Bleeding in post-operative tumor cavity: none10/160,6.25%;punctuate hemorrhage 4/12,33.33%;hematoma 4/11,36.36%.Pathology grade: Grade?-?13/66,19.70%;Grade? 3/70,4.29 %;Grade?2/47,4.26 %.Utilization of Depakine in vein after operation to prevent epilepsy: patients received anti-epileptic therapy 6/137,4.38%;patients not received anti-epileptic therapy 12/46,26.09%.Anti-epileptic therapy after operation: patients received anti-epileptic therapy 14/171,8.19%;patients not received anti-epileptic therapy 4/12,33.33%.2?SPSS 19.0 software was adopted to process above data,chi-square test was used to single factor analysis of absolute variable,t test to measurement data independent sample;P<0.05 indicated that the difference was statistically significant.The results showed that,preoperative epilepsy history(P=0.002),tumor localization(P=0.030),tumor resection degree(P=0.000),bleeding in post-operative tumor cavity(P=0.000),pathology grade(P=0.001),utilization of Depakine in vein after operation to prevent epilepsy(P=0.000),and anti-epileptic therapy after operation(P=0.020)were relevant factors of epileptic seizure in early period of postoperative brain glioma.However,the p values of gender,age,tumor size,peritumoral edema scope,operative approach and epileptic seizure in early period of postoperative brain glioma were greater than 0.05 without obvious statistical exception,so they were not relevant factors.The further multi-factor logistic regression analysis indicated that,preoperative epilepsy history,tumorlocalization,tumor resection degree,bleeding in post-operative tumor cavity and pathology grade were risk factors of epileptic seizure in early period of postoperative brain glioma.However,utilization of Depakine in vein after operation to prevent epilepsy,and anti-epileptic therapy after operation were the protective factors of epileptic seizure in early period of postoperative brain glioma.Conclusions:1?In this research,the incidence of epileptic seizure in early period of postoperative brain glioma is 9.84%,whose rate is higher.2?Patients' gender,age,tumor size,peritumoral edema scope,operative approach and epileptic seizure in early period of postoperative brain glioma are not risk factors.3?P<0.05 in preoperative epilepsy history,tumor localization,tumor resection degree,bleeding in post-operative tumor cavity,pathology grade,utilization of Depakine in vein after operation to prevent epilepsy,and anti-epileptic therapy after operation;the difference are statistically significant,which are relevant factors.4?Logistic regression analysis concludes that,preoperative epilepsy history,tumor closer to cortex,incomplete resection,post-operative tumor cavity,and low-grade glioma are the risk factors of epileptic seizure in early period of postoperative brain glioma.Utilization of Depakine in vein after operation to prevent epilepsy,and anti-epileptic therapy after operation are the protective factors of epileptic seizure in early period of postoperative brain glioma. |
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