手术治疗31例小儿颅咽管瘤临床分析

刘志雄, 刘运生, 袁贤瑞, 刘劲芳

中国当代儿科杂志 ›› 2009, Vol. 11 ›› Issue (08) : 663-665.

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中国当代儿科杂志 ›› 2009, Vol. 11 ›› Issue (08) : 663-665.
论著·临床研究

手术治疗31例小儿颅咽管瘤临床分析

  • 刘志雄,刘运生,袁贤瑞,刘劲芳
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Surgical treatment of childhood craniopharyngioma: clinical analysis of 31 cases

  • LIU Zhi-Xiong, LIU Yun-Sheng, YUAN Xian-Rui, LIU Jin-Fang
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摘要

目的:为了提高对儿童颅咽管瘤的诊断率以及减少术后并发症的发生,该研究探讨小儿颅咽管瘤的诊断方法、手术方式及术后并发症的防治。方法:回顾性分析31例小儿颅咽管瘤的临床表现、手术方法和术后并发症治疗的经验。结果:31例患儿主要临床表现为:头痛,视力下降,生长发育迟缓等。CT和MRI可确诊颅咽管瘤。31例颅咽管瘤中,肿瘤全切除 19例(61.3%),次全切除5例(16.1%),大部分切除7例(22.6%)。术后出现尿崩症者19例(61.3%),3例为长期性尿崩。6例(19.4 %)出现下丘脑损伤症状。无死亡病例。随访32.5个月, 5例(16.1%)患儿复发。结论:小儿颅咽管瘤的诊断主要依据临床表现、CT和MRI检查,该病以开颅手术治疗为首选。肿瘤切除的程度应考虑降低肿瘤的复发和减少并发症的发生为原则。[中国当代儿科杂志,2009,11(8):663-665]

Abstract

OBJECTIVE: To study the diagnosis, surgical treatment and outcome of craniopharyngioma in 31 children.MethodsThe clinical data of 31 children (aged 7-14 years) with craniopharyngioma were studied retrospectively. RESULTS: Headache, visusal disorder and growth retardation were main manifestations in the 31 children. The 31 children were definitely diagnosed with craniopharyngioma by CT and MRI. In the 31 cases, 19 (61.3%) underwent total tumor removal, 5 (16.1%) subtotal removal, and 7 (22.6%) partial removal. After tumor removal, transient diabetes insipidus occurred in 19 cases (61.3%) and long-term diabetes insipidus in 3 cases. Six cases (19.4%) presented hypothalamic injuries after surgery. No patient died after surgery. Five patients (16.1%) had recurrent tumor in a mean follow-up of 32.5 months.ConclusionsThe diagnosis of childhood craniopharyngioma may be based on clinical manifestations and CT/MRI examinations. Craniotomy is a preferred surgical treatment. Proper extent of tumor resection should be determined in order to reduce the tumor recurrence and the incidence of postoperative complications.[Chin J Contemp Pediatr, 2009, 11 (8):663-665]

关键词

颅咽管瘤 / 诊断 / 外科治疗 / 儿童

Key words

Craniopharyngioma / Diagnosis / Surgical treatment / Child

引用本文

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刘志雄, 刘运生, 袁贤瑞, 刘劲芳. 手术治疗31例小儿颅咽管瘤临床分析[J]. 中国当代儿科杂志. 2009, 11(08): 663-665
LIU Zhi-Xiong, LIU Yun-Sheng, YUAN Xian-Rui, LIU Jin-Fang. Surgical treatment of childhood craniopharyngioma: clinical analysis of 31 cases[J]. Chinese Journal of Contemporary Pediatrics. 2009, 11(08): 663-665
中图分类号: R739.41   

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