自发性颅内低血压患者脊髓脑脊液漏闭合术后与健康相关的生活质量的改善。

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY
Journal of neurosurgery. Spine Pub Date : 2024-06-14 Print Date: 2024-09-01 DOI:10.3171/2024.4.SPINE231232
Christopher Marvin Jesse, Ralph T Schär, Thomas Petutschnigg, Johannes Goldberg, Tomas Dobrocky, Eike Immo Piechowiak, Christoph J Schankin, Harri Sintonen, Andreas Raabe, Levin Häni
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引用次数: 0

摘要

目的:自发性颅内低血压(SIH自发性颅内低血压(SIH)是脊髓CSF渗漏导致的正压性头痛的一个重要原因。它对患者的社会经济状况和健康相关生活质量(HRQOL)有很大的负面影响。本研究旨在分析手术和血管内治疗对患者 HRQOL 的影响:作者开展了一项前瞻性观察性队列研究,纳入了 2022 年 4 月至 2023 年 5 月期间在其所在机构接受显微手术或栓塞治疗的所有 SIH 患者,具体取决于 CSF 漏的类型。研究人员要求患者在治疗前和治疗后3个月完成一份专门设计的问卷以及15D HRQOL问卷:研究期间,共有 21 名患者(14 名女性;平均年龄 51.7 岁)接受了治疗。其中,12 例(57%)为 1 型渗漏,3 例(14%)为 2 型渗漏,6 例(29%)为 3 型渗漏。20例(95.2%)渗漏发生在胸椎,只有1例(4.8%)发生在腰椎。所有患者都填写了调查问卷。15例(71.4%)患者接受了显微手术,6例(28.6%)接受了血管内栓塞治疗。平均 15D 评分从治疗前的 0.802 提高到治疗后的 0.889(P = 0.013)。与年龄和性别匹配的普通人群相比,SIH 患者在治疗前的 HRQOL 明显受损。治疗后,作者发现患者与健康人群的总体 HRQOL 没有明显差异。数字评分表上的平均头痛强度从治疗前的 8.1 改善到治疗后的 2.3(p = 0.003)。患者表示,SIH 对他们的社交和工作生活造成了显著影响:结论:SIH 对患者的 HRQOL 有相当大的负面影响。显微手术或栓塞治疗可显著改善患者的 HRQOL、主观健康感知和头痛强度。因此,鉴于观察到 SIH 患者的 HRQOL 有所改善,应考虑手术或血管内治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Improvement of health-related quality of life after closure of spinal CSF leaks in patients with spontaneous intracranial hypotension.

Objective: Spontaneous intracranial hypotension (SIH) is an important cause of orthostatic headaches caused by spinal CSF leaks. It has a strong negative impact on patients' socioeconomic status and health-related quality of life (HRQOL). This study aimed to analyze the impact of surgical and endovascular treatments on patients' HRQOL.

Methods: The authors conducted a prospective, observational cohort study that included all patients treated for SIH with microsurgery or embolization, depending on the type of CSF leak, at their institution between April 2022 and May 2023. Patients were asked to complete a specifically designed questionnaire, as well as the 15D HRQOL questionnaire, before and 3 months after treatment.

Results: A total of 21 patients (14 female; mean age 51.7 years) were treated in the study period. There were 12 (57%) type 1 leaks, 3 (14%) type 2, and 6 (29%) type 3. While 20 (95.2%) leaks were localized in the thoracic spine, only 1 (4.8%) was found in the lumbar spine. All patients completed the questionnaires. Fifteen (71.4%) patients underwent microsurgery and 6 (28.6%) endovascular embolization. The mean 15D score improved from 0.802 before to 0.889 after treatment (p = 0.013). Compared with an age- and sex-matched general population, HRQOL was significantly impaired in patients with SIH before treatment. After treatment, the authors found no significant difference in the overall HRQOL between patients and the healthy population. Mean headache intensity on a numeric rating scale improved from 8.1 before treatment to 2.3 after treatment (p = 0.003). Patients reported that SIH had a notable impact on their social and working life.

Conclusions: SIH has a considerable negative impact on HRQOL. Microsurgery or embolization can dramatically improve HRQOL, subjective perception of health, and headache intensity. Therefore, surgical or endovascular treatment should be considered given the improvement observed in HRQOL for patients with SIH.

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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
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