儿童小脑星形细胞瘤的外科治疗策略和预后

Microsurgical Strategy and Outcome of Pediatric Cerebellar Astrocytoma:93 Cases Report

目的探讨儿童小脑星形细胞瘤的外科手术治疗策略和预后。方法对经显微外科手术治疗的93例儿童小脑星形细胞瘤病例进行回顾性分析。结果手术全切除85例,近全切除8例。术前行肿瘤囊腔穿刺21例,侧脑室外引流9例,侧脑室-腹腔分流术23例。8例行术后放疗。28例术后进行康复训练,25例明显改善神经功能障碍。随访时间为26个月～5年,失访8例。无死亡和复发病例。Karnofsky行为状态评分均大于90分。结论显微外科手术切除治疗儿童小脑星形细胞瘤疗效满意。通过提高手术切除率,有效的围手术期处置和早期康复训练,患儿可获得长期且良好的生存。

Objective To investigate the strategy and effect of microsurgical treatment for pediatric cerebellar astrocytoma.Methods93 cases of pediatric cerebellar astrocytoma were reviewed who received microsurgical operation.ResultsTotal removal was achieved in 85 cases while subtotal in 8 cases.Pre-operatively,tumor capsule puncture was performed in 21 cases,lateral ventricle puncture and draining in 9 cases and ventricle-peritoneal shunt in 23 cases.Post-operative radiotherapy was performed in 8 cases.They were followed up for 26 months to 5 years with 8 cases lost.There was no death and recurrence.Scores of Karnofsky Performance Status（KPS）was more than 90 in all cases followed up.ConclusionPediatric cerebellar astrocytoma can be treated satisfactorily with microsurgery.By improving surgical removal rate,reasonable peri-operative treatment and early rehabilitation,children with cerebellar astrocytoma can achieve long and excellent living status.