摘要
目的评估脑干胶质瘤致脑积水的发生率、治疗策略的选择、脑积水对患者生存率的影响,总结临床特点。方法回顾47例不适宜手术切除的儿童弥漫性脑干胶质瘤病例,分析临床特点及治疗策略和预后等。结果 10例患儿发生脑积水,年龄中位数为6.3岁(6.9±4.2岁);自肿瘤确诊至脑积水发生所经历的时间间隔其中位数为3.3个月[(165.0±12.1)d];自脑积水发生至患儿死亡所经历的时间间隔其中位数为86 d[(159.1±10.8)d];10例脑积水患儿中8例接受VP分流术,其中2例术后持续颅内高压而接受二次分流术;2例接受ETV,其中1例因ETV失败进而行VP分流;脑积水组患儿1年生存率为34%,无脑积水组患儿1年生存率为38%,两组患儿总的1年生存率为32%,两组生存率差异无统计学意义(P>0.05);脑积水组平均总生存时间为10.6个月,无脑积水组平均总生存时间为8.7个月,两组差异不明显(P>0.05)。47例患儿平均总的存活时间为8.53个月,中位数为8.7个月。结论脑干胶质瘤致脑积水的形成与否对患者的生存率没有显著影响,它的形成并不代表肿瘤已步入进展末期;VP分流术应当作为治疗的首选。
Objective To assess the incidence of hydrocephalus associated to brain stem glioma, the choice of treat- ment, the impact of hydrocephalus on patients＇ overall survival rate, and to summarize the clinical features. Methods We conducted a retrospective review of 47 children with diffuse brain stem glioma unable to undergo surgery and then analyzed their clinical features, treatment strategy and prognosis. Results Ten children developed hydrocephalus due to pontine tumors,with 6 boys and 4 girls, whose median of age was 6.3 years （6.9±4.2 years）. The median of time interval from tumor diagnosis to the occurrence of hydrocephalus is 3.3 months （165.0±12.1 days）, while that from occurrence of hydrocephalus to death is 86 days （159.1±10.8 days）. 8 of 10 hydrocephalus children were treated by VP shunt,while the other 2 received ETV. 2 in the 8 VP shunt children represented continuous high intracranial pressure postopera- tively and then second surgery was performed respectively. 1 in the 2 ETV children was failure in the procedure and then received VP shunt. Hydrocephalus group children had a 1 year survival rate 34%, P 〉 0.05 vs. that of non-hy- drocephalus group 38%. The overall 1 year survival rate of the 2 group is 32%. The average survival time of hydro- cephalus group was 10.6 months, P 〉 0.05 vs. that of non-hydrocephalus group 8.7 months. The average overall sur- vival time of the 47 children was 8.53 months, with median 8.7 months. Conclusion The formation of hydrocephalus associated to brain stem glioma or not did not significantly affect the survival rate of patients. Hydrocephalus does not mean that the tumor has entered the final of progress. VP shunt surgery should be used as the first option to treat hy- drocephalus
出处
《中国现代医生》
2013年第17期136-138,141,共4页
China Modern Doctor
