小儿下丘脑胶质瘤的诊断和治疗

Diagnosis and Treatment of Hypothalamic Gliomas in Children

目的 为探讨小儿下丘脑胶质瘤的临床特点、诊断及治疗。方法 对1996年11月至2001年9月间收治的27例小儿下丘脑胶质瘤作回顾性分析。结果 27例小儿下丘脑胶质瘤占同期小儿颅内肿瘤的1.9％,占鞍区肿瘤的6.9％。临床表现主要为颅内压增高和下丘脑损害。27例中全切除4例和次全切除17例和大部分切除6例,无死亡病例。其中21例术后行放疗。随访23例,效果满意19例,生活能自理3例,植物生存1例。结论 小儿下丘脑胶质瘤诊断应根据临床表现及神经放射学检查综合分析。显微外科手术治疗是主要有效的治疗方法,未全切除者术后应放疗。

Objective To explore the clinical features, diagnosis and management of hypothalamic gliomas in children. Methods The clinical and imaging data of 27 cases of hypothalamic gliomas in children from November, 1996 to September, 2001 were analyzed retrospectively. Results Twenty-seven cases hyppltalamioc gliomas children accounted for 1.9% of all the intracranial tumors and 6.9% of the sellar tumors in children in the same period. The main clinical manifestations were induced by high ICP and hypothalamic lesions. Of 27 children with hypothalamic glioma, 4 received total resection of tumors, 17 subtotal and 6 in great part. No patients died from the operation. Twenty-one cases received radiotherapy after the operations. Of 23 cases followed up from 8 months to 5 years, 19 were good, 3 fair and 1 bad. Conclusions The diagnosis of hypothalamic glioma in children mainly relies on analysis of its clinical manifestations and neuroradiological examinations. Microsurgery is a main and effective method of treating the hypothalamic glioma and radiotherapy should be performed in the patients with untotally removed gliomas.