神经内镜辅助显微手术治疗儿童颅内肿瘤的效果及安全性研究

Clinical efficacy and safety of endoscopic assisted microsurgery for intracranial tumors in children

目的探讨神经内镜辅助显微手术治疗儿童颅内肿瘤的临床效果以及安全性。方法选取2014-02—2016-01收入郑州大学附属儿童医院的颅脑肿瘤患儿70例,按照随机数字表法随机分成对照组和观察组,每组35例。对照组患儿予以行显微手术治疗,观察组患儿则予以行神经内镜辅助下的显微手术治疗。治疗后分别对2组患儿的手术切除率、术后并发症进行比较。院后对患儿进行为期2 a的术后随访,并对2组患儿在随访期间的复发率、病死率等预后情况进行比较。结果(1)观察组的肿瘤全切除率(97.14%)显著高于对照组(77.14%),而观察组肿瘤次全切除率(2.86%)明显高于对照组(22.86%),差异有统计学意义(χ^2=4.202、4.590;P<0.05);(2)对照组术后并发症发生率为34.29%,显著高于观察组的14.29%,差异有统计学意义(χ^2=5.430;P<0.05);(3)66例患儿在随访期间均能正常生活、学习,观察组复发率为2.86%,显著低于对照组的18.75%,差异有统计学意义(χ^2=4.927;P<0.05)。结论对儿童颅脑肿瘤采用神经内镜辅助显微手术进行治疗,能够有效提高肿瘤的切术率,减少术后并发症发生情况,具有较好的安全性以及预后。

Objective To explore the clinical efficacy and safety of endoscopic assisted microsurgery for intracranial tumors in children.Methods 70 children with craniocerebral tumors admitted to our hospital from February 2014 to January 2016 were randomly divided into control group and observation group according to the random number table method,with 35 cases in each group.The control group was treated with microsurgery,while the observation group was treated with neuroendoscope-assisted microsurgery.After treatment,the surgical resection rate and postoperative complications were compared between the two groups.The children were followed up for 2 years after hospitalization,and the recurrence rate,mortality and other prognosis were compared between the two groups.Results①The total tumor resection rate(97.14%)in the observation group was significantly higher than that in the control group(77.14%).The subtotal tumor resection rate(2.86%)in the observation group was significantly lower than that in the control group(22.86%)(χ^2=4.202,4.590,P<0.05).②Postoperative complications occurred in 34.29%of the children in the observation group and 14.29%of the children in the control group.The incidence of complications between the two groups was statistically significant(χ^2=5.430,P<0.05).③The recurrence rate of the observation group was 2.86%,which was significantly lower than that of the control group(18.75%)(χ^2=4.927,P<0.05).Conclusion Endoscopic-assisted microsurgery for craniocerebral tumors in children can effectively improve the resection rate and reduce postoperative complications.It has good safety and prognosis,and is worthy of clinical promotion.