摘要
目的探索儿童鞍区肿瘤的有效手术治疗方法。方法回顾性分析53例儿童鞍区肿瘤患者的临床资料,其中颅咽管瘤29例,生殖细胞瘤7例,垂体瘤11例,表皮囊肿2例,星形细胞瘤1例,恶性畸胎瘤1例,神经鞘瘤1例,蛛网膜囊肿1例。29例患儿行经额下硬脑膜入路,13例经改良翼点入路,11例经蝶窦入路,16例行脑室-腹腔分流术。结果肿瘤全切除32例;次全切除16例;大部切除5例。术中22例可见垂体柄,均予保留。术后出现多饮多尿27例,其中20例在术后2周内恢复正常;出现高钠血症7例,低钠血症7例,均在2周内恢复正常,术后死亡2例。随访30例,其中3例术后1年内复发而再次手术,2例行γ-刀治疗,25例患儿术后可参加正常学习。结论选择合适的手术入路,并注意保护下丘脑结构,防止其供血动脉损伤,是儿童鞍区肿瘤手术治疗的原则和取得较好效果的关键。
Objective To study the effective method for surgical treatment of sellar region tumor in children. Methods 53 children with sellar region tumor were operated on. Of the 53 cases, 31 were male and 22 were female, with age ranging from 2 to 14 years (mean 10.3 years). The classification of the 53 patients as follows: craniopharyngioma in 29, germ cell tumors in 7, pituitary adenoma in 11, epidermoid cyst in 2, astrocyte tumor in 1, teratoma in 1, neurilemoma in 1, arachnoid cyst in 1. Subfrontal approach was performed in 29 cases, pterional approache in 13, trans-sphenoidal sinus approach in 11. Ventriculoperitoneal was performed in 16 patients. Results 32 patients had a total removal of tumor, 16 had a subtotal removal of tumor, and 5 had a partial removal of tumor. The pituitary stalk was preserved in 22 cases in the operation. 27 cases occured polydipsia and duresis after the operation, and 20 cases were recovered to normal in two weeks after the operation. 14 patients had abnormal blood sodium after the operation and all recovered in two weeks. 2 patients were died after the operation.30 patients were followed up for 1～3 years (mean, 1.6 years). 3 patients were re-operation within one year. 2 patients were treated by R-ray irradiation. Conclusions The proper surgical approaches for the removal of sellar region tumor ,avoid injury of hypothalamus structure and its blood-supple arteries are the key to achieve good surgical outcome.
出处
《临床小儿外科杂志》
CAS
2004年第1期52-54,共3页
Journal of Clinical Pediatric Surgery
