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儿童幕下髓母细胞瘤的诊断及显微手术治疗(附28例报道) 被引量:8

Diagnosis and microsurgical treatment of infratentorial medulloblastomas in children(report of 28 cases)
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摘要 目的探讨儿童幕下髓母细胞瘤(MB)的诊断及显微手术方法及其效果。方法回顾性分析2010年1月至2017年10月经术后病理证实的28例儿童幕下MB的临床资料。根据肿瘤与第四脑室和小脑的关系,运用小脑延髓裂入路10例,采用小脑延髓裂联合小脑蚓部微切开入路18例。结果肿瘤全切除25例,次全切除3例。围手术期无死亡。术后6个月,KPS评分100分8例,90分10例,80分5例,70分3例,60分1例,50分1例。27例术后随访8~79个月,平均50个月;20例进行足量、全程放、化疗,3例术后3年内仍原位复发;7例未听进行足量、全程放、化疗,1例术后1年椎管内种植转移,2例术后1.5年发生原位复发;23例生活自理(14例复课),4例死亡(生存时间为13~39个月,平均24个月)。结论 MB恶性程度很高,术后极易复发;术后及时予放、化治疗是必不可少的辅助措施,有利于防止肿瘤复发和播散转移;术前正确的入路选择、熟练应用显微手术技巧,是取得良好疗效、降低并发症的关键。 Objective To explore the diagnosis and mierosurgieal skills of infi'atentorial medulloblastomas in children. Methods The clinical dala of 28 children with the infralentorial medulloblastomas which were pathologically proved after the surgery between January, 2010 and Oetober, 2017 were analyzed retrospeetively. Of these 28 ehildren, 10 undm^vent mierosurgery via the eerebellomedullary fissure approach and 18 via eerebellomedullary fissure combined with eerebellar vermis mieroineision approach aeeording to the relationship of the tumors with the fourth ventriele and eerebellum. Results The tumors were totally reseeted in 25 children(89.2%) and subtotally in 3 (10.8%). No children perioperatively died and there were no postoperative complications related to the surgery in all the children. During a mean follow-up of 50 months (8-79 months), 23 of 27 patients, including 14 returning to school, took care of themselves and 4 of 27 patients died. Conclusion The correct choice of surgical approach before the operation and skilled mierosurgieal teehnique are the keys to good eurative effeet and redueing eompliealions in the ehildren with infratentorial medulloblastomas.
作者 王陈 汪立刚 胡力 唐义锋 杨孔宾 WANG Chen;WANG Li-gang;HU-Li;TANG Yi-feng;YANG Kong-bin. Department of Neurosurgery;The First Affliated Hospital;Harbin Medical University;Harbin 150001;China
出处 《中国临床神经外科杂志》 2018年第5期305-307,共3页 Chinese Journal of Clinical Neurosurgery
关键词 髓母细胞瘤 幕下 儿童 显微手术 Infratentorial medulloblastomas Children MierosurgmT Surgical approach
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  • 1刘维生,陈善文,赵继宗,王硕.小脑后下动脉瘤的显微外科治疗[J].首都医科大学学报,2008,29(3):387-390. 被引量:7
  • 2陈风华,方加胜,刘景平,姜维喜,刘劲芳.枕下开颅术后皮下积液的预防[J].中国医学工程,2006,14(3):273-274. 被引量:14
  • 3罗世祺.小儿颅内肿瘤[M].北京:人民卫生出版社,1992:105-116.
  • 4Yaargil M G, Abdulrauf S I. Surgery of intraventricular tumors[J]. Neurosurgery, 2008, 62 (6 Supp 13) :1029- 1040.
  • 5Tanriover N, Ulm A J, Rhoton A L Jr, et al. Comparison of transvennian and telovelar approach to the fourth ventricle [J]. J Neurosurg, 2004, 101(3) :484-498.
  • 6Deshmukh V R, Figuueiredo E G, Deshmukh P, et al. Quantification and comparison of telovelar and transvermian approaches to the fourth ventricle [ J ]. Neurosurgery, 2006, 58(4 Suppl 2) :202-206.
  • 7Turgut M. Cerebellar mutism [ J ] . J Neurosurg Pediatrics, 2008, 1(3) :262.
  • 8Kotil K, Eras M, Akgetin M, et al. Cerebellar mutism following posterior fossa tumor resection in children [ J ]. Turk Neurosurg, 2008, 18(1) :89-94.
  • 9Majchrzak H, Tymowski M, Majchrzak K, et al. Surgical approaches to pathological lesions of the middle cerebellar peduncle and the lateral part of the pons-clinical observation [ J ] . Neurol Neurochir Pol, 2007 , 41 (5) :436-444.
  • 10Ucerler H, Saylam C, Cagli S, et al. The posterior i:derior eerebellar artery and its bratiehes in relation to the eerebellomedullary fissure[J]. Clin Anat, 2008, 21(2) : 119- 126.

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