颅后窝髓母细胞瘤的治疗(附89例临床分析)

目的　对近几年收治的儿童髓母细胞瘤患者的临床资料进行回顾性分析 ,旨在提高对该疾病的认识和治疗效果。方法　 89例全部采用手术切除加术后放疗。结果　手术全切除 72例、次全切除 17例 ;术后 2例死于脑干功能衰竭 ,2例术后 2月出现脑积水 ,3例出现缄默症 ,2例上消化道出血 ,所有患者均有不同程度的发热 ;随访 5 2例 ,术后 3年无瘤生存 49例 ,桥小脑角 1例术后 7年原部位复发。结论　手术应尽量全切并注意保护脑干及蛛网膜下腔 ,若肿瘤较大者应首先分块切除中心部位 ,减少体积后再沿边界切除 ,以减少术后并发症 ;术后放疗应作为常规治疗手段 ,放疗范围及剂量应视患者年龄而定。

The Treatment of Medulloblastoma in Posteriofossa (89 Cases of Patients)

Objective To improve the understanding and therapeutic effect for children's medulloblastoma, the retrospectively analysis of the recent clinical data were carried out in this article. Methods All of 89 cases were evacuated by surgical operation and postoperative radiotherapy. Results The tumors in 72 cases were resected completely, and 17 cases removed mostly; 2 cases died due to the failure of brain stem function. 2 cases appeared hydrocephalus 2 month later; 3 cases had mutism, and 2 cases with upper alimentary tract hemorrhage. All patients had different fever. 52 cases were followed up. 49 cases without tumors survived, and 1 case with cerebellopontine angle tumor recurred seven years later in original site. Conclusion Neurosurgeon should remove the tumors utmostly and protect the brain stem and subarachnoid space cautiously from damage during operation. To decrease the postoperative complications, we should firstly remove the tumors in the center partly if the tumors were big; and then to resect along the tumors margin after tumors volume was reduced. Postoperative radiotherapy should be applied as a routine method, and radiotherapeutic area and dosage ranged according to patient's age.