Analysis Of Related Factors Of Early Postoperative Seizure In Glioma

Objective:To explore the related factors of early postoperative epileptic seizures in gliomas.Methods : The clinical data of 476 glioma patients who met the inclusion criteria for craniotomy at the Bethune First Hospital of Jilin University from January2016 to January 2018 were collected.Screening out patient gender(male/female),age(<15 years;15-59 years old;> 59 years old),history of preoperative or postoperative epilepsy(with/without),presence or absence of intratumoral hemorrhage(with/without),presence or absence of tumor Peritoneal edema(with/without),tumor volume size(<3cm;3cm-5cm;>5cm),tumor location(forepart,other parts of temporal lobe),tumor WHO grade(grade I-II;grade III;grade IV)surgical approach(Prefrontal approach(temporal leaf approach)temporal approach other surgical approaches).Statistics of patients' sex,age,preoperative epilepsy,tumor volume,peritumoral edema,tumor location,surgical approach,intratumoral hemorrhage,tumor WHO grade and postoperative epilepsy related factors.Using SPSS13.0 software,a retrospective univariate,multivariate logistic regression analysis was performed to identify risk factors for early seizures in patients with glioma.P < 0.05 indicates that the difference was statistically significant.Results : This study of 476 cases of glioma patients in early postoperative seizures in 53 cases,the incidence rate was 11.1%.Postoperative epilepsy in 19 males(19/235,8.1%),and 34 women with epilepsy(34/241,14.1%);less than 15 years of age group occurred postoperative epilepsy in 1 case(1/21,4.8%),epilepsy occurred in 38 patients in the age group of 15 to 59 years(38/335,11.3%),epilepsy occurred in 14 patients in the group of patients older than 59 years old(14/120,11.7%).There were40 cases of epilepsy in the group without history of epilepsy(40/371,10.8%),epilepsy occurred in 13 patients with preoperative epilepsy history(13/105,12.4%),25 epilepsy patients had postoperative hemorrhage(25/156,16.0%),There were 28 cases of epilepsy with tumor-free hemorrhage group(28/320,8.8%),There were 47 cases with peritumoral edema group(47/360,13.1%),6 cases of epilepsy with peritumoral edema group(6/116,5.2%);Tumor volume was less than 3cm group,epilepsy occurred in 17 patients(17/167,10.2%),There were 31 cases in 3cm to 5 cm group(31/268,11.6%),and epilepsy occurred in 5 patients above the 5cm group(5/41,12.2%),there were 43 cases of epilepsy(43 / 366,11.7%),in the frontal and temporal lobe groups,and 10 cases of epilepsy in the other sites(10/110,9.1%);Twenty-two patients in the WHO grade I-II group had epilepsy(22/139,15.8%),14 patients in the WHO grade III group had epilepsy(14 / 96,14.6%),and 17 patients in the WHO grade IV group had Epilepsy(17/241,7.1%).Univariate analysis showed that patients with postoperative edema,intratumoral hemorrhage,tumor grade I-II,and female patients were more prone to postoperative epilepsy.The difference was statistically significant(p<0.05).Further multivariate logistic regression analysis showed that the patient had postoperative edema in the tumor area,haemorrhage in the tumor cavity,tumor grade I-II,and women as risk factors.Postoperative edema,intratumoral hemorrhage,and tumor grade I-II The female OR values were 2.753,1.990,1331 and 1.867.Conclusion:1,Age,preoperative epilepsy,tumor volume,tumor location,and surgical approach are not risk factors for early postoperative seizures in glioma patients;2,Postoperative peritumoral edema,intratumoral hemorrhage,tumor grade(WHO I-II grade),and female patients are risk factors for early postoperative seizures in glioma patients.Special attention should be paid to the postoperative patients with the above-mentioned related risk factors,as early as possible to prevent epilepsy prevention measures,rational use of epilepsy drugs to reduce the incidence of early postoperative patients with epilepsy.