儿童颅咽管瘤术后常见并发症的处理

The management of postoperative complications in pediatric craniopharyngioma

目的探讨儿童颅咽管瘤术后常见并发症的特点及处理原则。方法回顾性研究我院28例出现并发症的颅咽管瘤手术患儿,分析常见的并发症及其与成年人的不同,研究处理原则。结果28例患儿手术全切除22例,次全切除5例,大部分切除1例,术后3例患儿死亡。术后常见并发症依次为:尿崩症、电解质紊乱、高热、意识障碍、癫痫、脑脊液漏、上消化道出血、视力、视野损害、肺水肿。结论儿童颅咽管瘤病理类型多为釉质型,儿童患者手术耐受力差,年龄越小,出现并发症后的病死率越高。尿崩症、电解质紊乱是最常见的并发症,癫痫和肺水肿是致命的并发症。

Objective To explore the characteristics and management of postoperative complications in pediatric craniopharygioma. Methods The clinical data from 28 cases were retrospectively analyzed. The presentation and management of these complications in children were analyzed and compared with those in adults. Results Twenty-two cases underwent whole tumor removal, 5 with subtotal removal and 1 with partial removal. Among them, 3 cases died. The complications included： diabetes insipidus, hypernatremia or hyponatremia, hyperpyrexia, conscious disturbance, seizure, leakage of cerebrospinal fluid, upper gastrointestinal hemorrhage, vision and visual field disturbance and pulmonary edema. Conclusions The younger children with the craniopharygioma may have the higher occurrence of complications after operation.