小儿颅脑肿瘤28例临床分析

Clinical analyses of intracranial tumor in children:report of 28 pediatric cases

为了分析小儿颅内肿瘤的临床诊断和治疗特点,收集28例颅内肿瘤患儿的临床资料及实验室检查、颅脑CT和MRI结果,并进行临床分析。28例患者发病年龄1～3岁5例,3～7岁12例,7～14岁11例。小脑蚓部髓母细胞瘤4例,小脑蚓部星形细胞瘤5例,室管膜瘤4例,颅咽管瘤3例,脑干肿瘤2例,大脑半球胶质瘤2例,松果体区肿瘤2例,畸胎瘤2例,不能确定性质4例。有16例首诊时被误诊。初步研究结果提示,颅内肿瘤易误诊,应对顽固性呕吐、脑炎、脑膜炎、颅内高压的表现、脑积水尤其合并智力低下患儿做详细体检和影象学检查,尽早确诊,为患儿争取早期适当的治疗。

To investigate the clinical features in diagnosis and therapy of childhood intracranial tumors; Comprehensive analysis of the clinical data and laboratory examination, cerebral CT and MRI images of 28 pediatric patients with intracranial tumors were performed. Of the 28 cases, 5 were 1-3 years old, 12 were 3-7 years old and 11 were 7-14 years old. The lesions included medulloblastoma in vermis cerebellum （n=4）, astrocytoma in vermis cerebellum （n = 5）, ependymoma （n = 4）, craniopharyngioma （n = 3 ）, brain stem tumor （n = 2）, teratoma （n = 2 ）, neurogliocytoma in cerebral hemisphere （n=2）, tumors in pineal body （n=2）, and tumors with uncertain nature （n=4）. 16 cases were misdiagnosed at the first visit. Intracranial tumors in children are easily misdiagnosed. It should be taken careful physical and imaging examination to the children who appears intractable vomiting, headache, encephalitis, meningitis, intracranial hypertension or hydrocephalus, especially accompany mental retardation, to reach a final diagnosis and then select appropriate treatment.