文摘
摘要目的:比较一年期的功能性结果NMDArE患者接受激进与保守的卵巢切除术。
背景:切除卵巢畸胎瘤患者anti-N-methyl-D-aspartate受体脑炎(NMDArE)与显著地提高神经系统有关。目前缺乏证据的相对安全性和有效性不同的手术治疗方法。
设计/方法:NMDArE患者接受卵巢切除术1月1日之间圣2012年12月31日圣从两个三级中心2020年回顾性确定。主要结果是好的一年期功能状态,定义为改良Rankin规模(夫人)0 - 2分。激进的方法是定义为一个一步双边卵巢切除术或卵巢切除术术前影像畸胎瘤的证据。Fisher精确检验和Wilcoxon测试被用来比较两组。然后我们进行了固定效应分析将从这个研究结果与其他研究报告功能结果基于如上定义的手术方法。
结果:15个患者被纳入研究。在脑炎发病平均年龄24岁(范围:19 - 73)。平均延迟从出现症状到手术36天(范围:16 - 129)。七个病人(47%)接受积极的手术方法。4 7例(57%)患者的积极方法组有一个好结果,与6/8(75%)相比,在保守的方法组(p = 0.61)。没有统计上显著的差异在延迟从出现症状到治疗ICU停留的长度,或年龄在两组之间。一项研究是包括在荟萃分析(n = 29,戴et al . 2019),显示无统计差异之间的两种手术方法(p = 0.18)。
结论:激进的(与保守的)卵巢切除似乎并没有改善神经结果NMDArE患者之一。临床医生应该使用要谨慎考虑这样的手术方法。
披露:艾杨格没有披露。赫伯特博士没有披露。Climans博士没有披露。Muccilli博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会生原体。Muccilli博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会诺华。Muccilli博士已经收到个人薪酬在500 - 4999美元的范围为在科学咨询服务或数据安全监测委员会EMD Serono。天已收到博士个人薪酬在5000 - 9999美元的范围为Parabon Nanolabs担任顾问。天已收到博士个人薪酬在500 - 4999美元的范围作为一个编辑,副主编,或编辑顾问委员会成员力学(EBSCO健康)。天已收到博士个人薪酬在10000 - 49999美元的范围为巴罗法作为专家证人。天已收到博士研究机构国立卫生研究院/ NIA的支持。 The institution of Dr. Day has received research support from Chan Zuckerberg Initiative. The institution of Dr. Day has received research support from Alzheimer's Association. The institution of Dr. Day has received research support from National Institutes of Health / NINDS. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at regional meeting (CME) with Texas Neurological Society. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Grant Review (honorarium) with Pennsylvania Department of Health . Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Presenter at Annual Meeting (CME) with American Academy of Neurology. Dr. Day has received personal compensation in the range of $500-$4,999 for serving as a Content Development (CME) with PeerView, Inc. Dr. Day has received personal compensation in the range of $5,000-$9,999 for serving as a Content Development (CME) with Continuing Education, Inc. Dr. Day has a non-compensated relationship as a Clinical Director with AntiNMDA Receptor Encephalitis Foundation that is relevant to AAN interests or activities. Dr. Wennberg has nothing to disclose. Dr. Tang-Wai has nothing to disclose.
