摘要：

目的: 探讨内镜下经鼻或经口入路颅底脊索瘤切除术后生活质量与临床和影像学特征的相关性。方法: 回顾总结2016年3月至2022年3月在天津市环湖医院行内镜下经鼻或经口入路手术的14例颅底脊索瘤患者的临床和影像学特点，采用36条简明健康状况调查表（SF-36）评价手术后生活质量，采用Point-Biserial相关分析和偏相关分析探究SF-36评分及其各维度评分与临床和影像学特征的相关性。结果: 相关分析显示，SF-36评分中躯体健康总分之躯体疼痛维度评分与头痛（r = -0.998，P = 0.043）、复视（r = -0.999，P = 0.032）、视力障碍（r = -0.998，P = 0.037）、海绵窦症状（r = -0.997，P = 0.047）、肿瘤次全切除或大部切除（r = -0.998，P = 0.038）呈负相关，与术后放射治疗（r = 0.998，P = 0.038）、全斜坡型肿瘤（r = 0.998，P = 0.036）、肿瘤体积 > 20 cm³（r = 0.999，P = 0.035）呈正相关。结论: 脊索瘤患者可存在术前头痛、复视、视力障碍、海绵窦症状以及术中肿瘤次全切除或大部切除的特征，可降低内镜下经鼻或经口入路手术后生活质量，临床对此类患者应予以关注。

关键词: 脊索瘤, 颅底, 生活质量, 神经内窥镜检查, 显微外科手术

Abstract:

Objective: To investigate the correlation between clinical symptoms and imaging features with quality of life in patients after endoscopic transnasal or transoral approach for resection of skull base chordoma. Methods: The clinical and imaging data of 14 patients with skull base chordoma who underwent endoscopic transnasal or transoral approach for resection in Tianjin Huanhu Hospital from March 2016 to March 2022 were retrospectively analysed. Quality of life after endoscopic skull base chordoma resection was measured by 36-Item Short-Form Health Survey (SF-36). The correlation between clinical symptoms and imaging features with SF-36 was investigated using Point-Biserial correlation and partial correlation analyses. Results: Correlation analyses indicated that headache (r = -0.998, P = 0.043), diplopia (r = -0.999, P = 0.032), visual disturbance (r = -0.998, P = 0.037), sinus symptoms (r = -0.997, P = 0.047), subtotal or most partial removal (r = -0.998, P = 0.038) were negatively correlated with body pain in SF-36, while postoperative radiotherapy (r = 0.998, P = 0.038), total clival tumor r = 0.998, P = 0.036) and tumor volume > 20 cm³ (r = 0.999, P = 0.035) were positively correlated with body pain in SF-36. Conclusions: Patients with skull base chordoma who have headache, diplopia, visual disturbance, sinus symptoms, and subtotal or most partial removal possibly have reduced quality of life after endoscopic resection. The patients with the clinical symptoms and imaging features above deserve more attention.

Key words: Chordoma, Skull base, Quality of life, Neuroendoscopy, Microsurgery