儿童期颅咽管瘤的诊断与经蝶显微手术治疗

Diagnosis and Transsphenoidal Microsurgical Removal of Craniopharyngiomas in Children

目的 提高儿童期颅咽管瘤的诊断水平与手术治疗效果。方法 回顾性总结 2 5例颅咽管瘤的诊断措施 ,手术技巧和治疗结果。本组均经 CT或 MRI扫描确诊。手术采取经蝶入路行肿瘤切除术。结果 1 3例肿瘤获全切除 ;8例次全切除 ;余 4例为部分切除 ,术后无死亡。2 0例获长期随访 (平均 3.6年 ) ,其中 1 7例 (85.0 % )恢复良好 ,3例 (1 5.0 % )肿瘤复发 ,需行再次手术治疗。结论 对儿童期颅咽管瘤采用 CT或 MRI进行诊断并选择合适病例经蝶入路显微手术切除 ,是一种安全、有效的方法。

Objective To improve the diagnostic level and surgical curative effect of craniopharyngioma in children.Methods We retrospective reviewed the diagnostic procedures,surgical technique,and outcome of 25 patients with craniopharyngioma.Diagnosis was made by means of CT or MRI scan.Operations were performed via transsphenoidal approach to remove the tumors.Results Total removal of the tumor in 13 cases,subtotal removal in 8 cases and partially removal in remaining 4 cases were achieved.There was no postoperative mortality in this group.Long term followup review (median 3.6 years)in 20 patients revealed good recovery of 17 patients (85.0%),contrasted with 15.0%(3 cases)late recurrence rate after operations.This patients with recurrence of tumor need to treat by again operative management.Conclusion It is a safe and effective method by using the CT or MRI to diagnose and microsurgical technique via transsphenoidal approach to remove craniopharyngioma for suitable pediatric patients.