儿童额叶肿瘤的执行功能评价

Evaluation of executive function of frontal brain tumors in children

目的探索额叶肿瘤对儿童患者的认知功能影响,确定额叶肿瘤患儿的执行功能损害特点。方法研究对象为45例儿童颅内肿瘤,年龄10～14岁,其中有25例额叶肿瘤,位于左额10例,右额15例;非额叶(颞叶、顶叶、脑室内或颞顶区)20例。所有患者均采用全麻下显微外科手术。术后病理证实:星形细胞瘤13例,室管膜瘤6例,少枝胶质细胞瘤4例,神经细胞瘤2例。运用威斯康星卡片分类测试系统对患者进行临床评价,并与30例同龄正常儿童作对照。结果威斯康星卡片(WCST)分类测试中的完成分类数(categoriesachieved)和持续性错误(preservativeerrors)两个指标在额叶肿瘤组和非额叶肿瘤组之间有统计学意义,而左额肿瘤组患者的执行功能损害较右额肿瘤组、非额叶肿瘤组和正常组差异有统计学意义,而右额肿瘤组与非额叶肿瘤组和正常组没有统计学意义。结论左额叶肿瘤患儿存在明显的执行功能障碍,而右额肿瘤引起损害则不明显。

Objective To investigate the influence of cognitive function associated with frontal brain tumors in children, in order to find out the harmful characteristic of executive dysfunction in patients suffering from frontal brain tumors. Methods 45 patients with brain tumors were measured by the Wisconsin Card Sorting Test （WCST） on executive dysfunction. There are twenty-five frontal, 20 non-frontal brain tumor patients, and 30 normal controls （NC）. The frontal tumor patients were also assigned to either a left frontal （n = 10） group or a right frontal group （n = 15） and compared with the non-frontal group （including temporal, parietal, intraventricle and temporal-parietal lobe） and NC. All patients were performed by microneurosurgery, the pathological results were astrocytomas （n = 13 ）, ependymas （n = 6） , Oligodendrogliomas （n =4） and center neurocytomas （n =2）. Results There was significant differences between the brain tumors group and NC according to categories achieved and preservative errors in the Wisconsin Card Sorting Test. Furthermore, executive dysfunction were affected more in the left frontal tumor group than other groups while the right frontal tumor group seemed no such pattern compared with non-frontal tumor group and NC. Conclusion Children suffering from the left frontal tumor show significantly executive dysfunction, and right frontal tumors show no significant difference.