[1]张晓静,高攀,程立冬,等.小儿后颅窝中线肿瘤的显微手术治疗[J].中国临床神经外科杂志,2017,(02):65-67.[doi:10.13798/j.issn.1009-153X.2017.02.001]
　ZHANG Xiao-jing,GAO Pan,CHENG Li-dong,et al.Microsurgery for posterior fossa midline tumors in children[J].,2017,(02):65-67.[doi:10.13798/j.issn.1009-153X.2017.02.001]
点击复制

小儿后颅窝中线肿瘤的显微手术治疗()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年02期
页码:
65-67
栏目:
论著
出版日期:
2017-02-20

文章信息/Info

Title:
Microsurgery for posterior fossa midline tumors in children
文章编号:
1009-153X（2017）02-0065-03
作者:
张晓静; 高攀; 程立冬; 赵恺; 张所军; 蒋; 伟; 舒凯; 雷霆
作者单位：430030 武汉，华中科技大学同济医学院附属同济医院神经外科（张晓静、高　攀、程立冬、赵　恺、张所军、蒋　伟、舒　凯、雷霆） 通讯作者：舒　凯，E-mail：kshu@tjh.tjmu.edu.cn
Author(s):
ZHANG Xiao-jing;  GAO Pan;  CHENG Li-dong;  ZHAO Kai;  ZHANG Suo-jun;  JIANG Wei;  SHU Kai;  LEI Ting.
Department of Neurosurgery, Tongji Hospital, Tongji Mdecal School, Huazhong University of Science & Technology, Wuhan 430030, China
关键词:
后颅窝中线肿瘤; 小儿; 显微手术; 疗效
Keywords:
Tumors;  Posterior fossa midline;  Children;  Microsurgery;  Complications
分类号:
R 739.41; R 651.1+1
DOI:
10.13798/j.issn.1009-153X.2017.02.001
文献标志码:
A
摘要:
目的 探讨小儿后颅窝中线肿瘤的临床特点和显微手术疗效。方法 回顾性分析2011年2月至2015年2月显微手术治疗的52例小儿后颅窝中线肿瘤的临床资料。结果 肿瘤全切除45例，次全切除5例，大部分切除2例。髓母细胞瘤36例（69.2%），室管膜瘤及间变性室管膜瘤7例（13.5%），星形细胞瘤7例（13.5%），少突胶质细胞瘤1例（1.9%），血管母细胞瘤1例（1.9%）。围手术期并发症发生率为44.2%（23/52）。术后无并发症短期内恢复良好29例，出现并发症延迟恢复19例，昏迷自动出院或死亡4例。康复的48例出院后随访3~48个月，平均15个月；7例肿瘤复发。结论 显微手术是治疗小儿后颅窝中线肿瘤最有效的方法，术中利用小脑延髓裂间隙显露切除肿瘤能有效减少脑组织损伤，加强围手术期并发症的处理可提高疗效。
Abstract:
Objective To explore the clinical features of posterior fossa midline tumors and microsurgical effects on them in children. Methods The clinical data of 52 children with posterior fossa midline tumors undergoing microsurgery in Tongji Hospital from February, 2011 to February, 2015 were analyzed retrospectively. Results Of 52 children with posterior fossa midline tumors, 45 received total resection of the tumors, 5 subtotal and 2 partial. The conditions were deteriorated in 4 children after the operation. Forty-eight children followed up from 3 to 48 months were recovered well after the operation. Conclusions Microsurgery is the best effective method to treat posterior fossa midline tumors in the children. Exposure and resection of the tumors by microsurgery through the cerebellomedullary fissure approach may reduce the operation-side injury to the cerebral tissues. The potent treatment of the perioperative complications is helpful to improvement of the prognoses in the children with posterior fossa midline tumors.

参考文献/References:

[1] 雷　霆，李　龄. 小儿神经外科学[M]. 北京：人民卫生出 版社，2011.
[2] D?rner L, Fritsch MJ, Stark AM, et al. Posterior fossa tumors in children: how long does it take to establish the diagnosis [J]. Childs Nervous System, 2007, 23(8): 887-890.
[3] Poretti A, Meoded A, Huisman TAGM. Neuroimaging of pediatric posterior fossa tumors including review of the literature [J]. J Magn Reson Imaging, 2012, 35(1): 32-47.
[4] Clarencon F, Bonneville F, Sicliez JP, et al. A typical loca- tion of a solitary fibrous tumor in the fourth ventricle [J]. J Neuroradiol, 2006, 33 (4): 279-280.
[5] Tabatabaei SM, Seddighi A, Seddighi AS. Posterior fossa tumor in children [J]. Iran J Child Neurol, 2012, 6(2): 19- 24.
[6] 黄茂华，罗正利，左楚清. 小儿脑室-腹腔分流术128例临 床分析[J]. 中华小儿外科杂志，2010，31（4）：308-310.
[7] 王忠诚. 王忠诚神经外科学[M]. 武汉：湖北科学技术出版 社，2005.
[8] 陈　龙，林志雄，梅文忠，等. 儿童后颅窝病变术后皮下积 液的成因及防治[J]. 中华神经外科杂志，2009，25（12）： 1103-1105.
[9] Gopalakrishnan CV, Dhakoji A, Menon G, et al. Factors predicting the need for cerebrospinal fluid diversion follow- ing posterior fossa tumor surgery in children [J]. Pediatr Neurosurg, 2012, 48(2): 93-101.
[10] Concezio DR, Daniela C, Paolo F. Heralding cerebellar mu- tism: evidence for pre-surgical language impairment as pri- mary risk factor in posterior fossa surgery [J]. Cerebellum, 2011, 10(3): 551-562.
[11] Ozgur BM, Berberian J, Aryan HE, et al. The pathophysio- logic mechanism of cerebellar mutism [J]. Surg Neurol, 2006, 66(1): 18-25.
[12] Robertson PL, Muraszko KM, Homes EJ, et al. Incidence and severity of postoperative cerebellar mutism syndrome in children with medulloblastama: a prospective study by the Children’s Oncology Group [J]. J Neurosurg, 2006, 105 (6 Suppl): 444-451.

相似文献/References:

[1]李　响　Raynald　朱婉春　宫　剑.小儿颅内胚胎癌1例[J].中国临床神经外科杂志,2016,(01):63.[doi:10.13798/j.issn.1009-153X.2016.01.024]
[2]申汉威　李俊卿　李红星　姜志超　汪立刚　杨世春　杨孔宾.小儿颅脑损伤的临床特点及治疗分析[J].中国临床神经外科杂志,2015,(04):231.[doi:10.13798/j.issn.1009-153X.2015.04.013]
[3]李　响,朱婉春,何锦涛,等.小儿头颅贯通枪伤1例[J].中国临床神经外科杂志,2016,(12):806.[doi:10.13798/j.issn.1009-153X.2016.12.030]
[4]张海泉　王志勇　敖祥生　刘汉东.脑室-腹腔分流术治疗小儿脑积水[J].中国临床神经外科杂志,2017,(01):34.[doi:10.13798/j.issn.1009-153X.2017.01.012]
[5]常晓赞,张荣伟,袁绍纪,等.小儿颅骨凹陷性骨折自发复位1例[J].中国临床神经外科杂志,2017,(07):527.[doi:10.13798/j.issn.1009-153X.2017.07.033]
[6]刘　叶　王贤书　曹红宾　王盛华　谷红霞　杜　娟　方江顺　孙志轩.小儿脑室-腹腔分流术后并发症分析[J].中国临床神经外科杂志,2020,(10):709.[doi:10.13798/j.issn.1009-153X.2020.10.017]
[7]康　伟　何丽芸　吉文玉.质量控制关键节点管理在小儿幕下肿瘤切除术中的效果评价[J].中国临床神经外科杂志,2020,(10):717.[doi:10.13798/j.issn.1009-153X.2020.10.021]
[8]刘元钦　张庆露　李翠玲　孙帅奇　张荣伟.小儿右侧顶叶软骨母细胞瘤1例[J].中国临床神经外科杂志,2021,26(06):491.[doi:10.13798/j.issn.1009-153X.2021.06.031]
[9]石　琦　黄　玮　余永佳　陈志毅.小儿右侧额颞顶叶原发性原始神经外胚层肿瘤1例[J].中国临床神经外科杂志,2022,27(04):321.[doi:10.13798/j.issn.1009-153X.2022.04.028]
[10]吴胜波,赵军,王磅博,等.小儿颅骨缺损自我修复1例[J].中国临床神经外科杂志,2023,28(04):283.[doi:10.13798/j.issn.1009-153X.2023.04.021]

更新日期/Last Update: 1900-01-01