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目的探讨儿童颅咽管瘤的手术疗效及复发因素。方法回顾性分析2005年1月—2011年1月儿童颅咽管瘤的手术治疗48例,部分行放射治疗,观察其治疗过程,治疗效果及复发因素。结果 48例全部行手术治疗,术中发现26例肿瘤侵犯邻近组织,显微切除肿瘤,镜下全切32例,次全切10例,术中减压6例。术后有2例死于下丘脑损伤,1例死于脑出血,1例死于电解质紊乱。术后观察半年以上,27例未见复发,7例肿瘤未见明显生长,14例肿瘤生长明显,需行再次治疗。结论儿童颅咽管瘤治疗是神经外科难题之一,其复发关键因素是手术能否全切,术后行放疗能够巩固其疗效,明显提高肿瘤生长控制率,延长患者生命。
Objective To investigate the surgical efficacy and recurrence factors of craniopharyngioma in children. Methods Retrospective analysis of January 2005 - January 2011 surgical treatment of children with craniopharyngioma in 48 cases, some of the line of radiation therapy to observe the course of treatment, treatment and recurrence factors. Results All the 48 cases underwent surgical treatment. Twenty-six cases of tumor were found to invade adjacent tissues and tumors were removed by microsurgical excision. Thirty-two cases underwent microsurgical resection, 10 cases underwent subtotal resection and 6 cases underwent decompression. Two patients died of hypothalamic injury, one died of cerebral hemorrhage, and one died of electrolyte imbalance. Postoperatively observed more than six months, 27 cases no recurrence, no significant growth in 7 cases of tumor, 14 cases of tumor growth obviously, need to be treated again. Conclusion The treatment of craniopharyngioma in children is one of the neurosurgery problems. The key factor of recurrence in children is whether the operation can be totally cut. Radiotherapy after operation can consolidate its curative effect, significantly improve the rate of tumor growth control and prolong the life of patients.