儿童第四脑室肿瘤的显微外科治疗_附40例报告_杨宏.pdfVIP

中华神经外科杂志2002 年11 月第18 卷第6 期　Chin J Neurosurg, November 2002, Vol.18, No.6 ·367 · ·小儿神经外科· 儿童第四脑室肿瘤的显微外科治疗 (附40 例 告) 方方 土 杨宏　朱建 　梁建民　黄勤　陆永建　曾白云　方泽鲁　岑宇翔 　　【摘要】　目的　提高儿童第四脑室肿瘤的手术效果。方法　回顾性分析我院自1997 年8 月至 2002 年8 月连续收治的40 例儿童第四脑室肿瘤。40 例均采用了显微手术治疗。结果　肿瘤全切除或 近全切除, 其中全切除26 例。术后全部清醒。术后脑积水15 例, 11 例行侧脑室-腹腔分流治疗。发生 术后缄默症6 例。 1例死于继发性脑干损伤, 1 例死于急性消化道大出血。结论　选择正常组织受损 最轻微, 暴露肿瘤最直视的部位分离肿瘤、 切除肿瘤及积极有效防治术后脑积水, 有助于提高手术质 量。 【关键词】　脑肿瘤　第四脑室　儿童　显微外科手术 Microsurgery of pediatric 4th ventricle tumor:report with 40 cases 　 YANG Hong, ZHU J iankun, LIANG Jianmin, et al.Dept.of Neurosurgery of 2nd Aff iliated Hospital of Guangzhou Medi al College, Guangzhou 510260, China 【Abstract】　Objective　To improve the surgical result in pediatric patients with 4th ventricle tumor.Meth- ods　40 cases of pediatric 4th ventricle tumor that have been operated in our department from August 1997 to August 2002 were anal zed retrospectivel .Results 　26 cases underwent total resection and 14 cases subtotal resection, all patients were conscious after surger , 15 patients suffered postoperative h drocephalus.Ventriculoperitoneal shunt was done in 11 patients, 6 patients presented mutism, 1 patient died b secondar brainstem injur , 1 patient died b a- cute digestive tract massive hemorrhage.Conclusions　It is helpful for improving the surgical result that choosing the list injur of brain tissue and the best exposure to manage tumor and activel prevent and treat postoperative h dro- cephalus. 【Key words】　Brain tumor　4th ventricle　Pediatric　Microsurger 　　第四脑室肿瘤, 主要指原发于第四脑室或自小 2.临床表现:主要症状为颅内压增高36 例 脑蚓部突入第四脑室的肿瘤。儿童第四脑室肿瘤占 (其中伴小脑躯干性共济失调20 例), 小脑躯干性 儿童幕下肿瘤的首位。要做到全切除或近全切除儿 共济失调3 例, 一侧第6、7 颅神经麻痹1例。 童第四脑室肿瘤, 同时不发生或少发生并发症, 困 3.影像学检查:全部患儿行头颅MRI 横断 难不小。我院从1997 年8 月至2002 年8 月共收治 位, 矢状位, 冠状位扫描, 提示肿瘤全部或近全部 经手术和病理证实的儿童第