儿童髓母细胞瘤的显微手术治疗——附24例报告

背景与目的：髓母细胞瘤是儿童常见的中枢神经系统恶性肿瘤，手术是其治疗的主要手段。本文通过对24例儿童髓母细胞瘤显微外科治疗分析，总结儿童髓母细胞瘤的显微手术经验。方法：收集1999-2007年我院经手术证实的儿童髓母细胞瘤24例，对其临床资料进行回顾性分析。其中男16例，女8例，平均年龄7．5岁，常见症状和体征为高颅压征和共济失调，全部患者均行显微手术治疗，术后辅助放射治疗。19例随访6个月至6年。结果：全组病例中，肿瘤全切21例，大部分切除2例，部分切除1例，手术死亡率4．2％（1／24），未出现严重并发症．患儿生存质量得到提高。结论：掌握显微手术方法和手术中注意事项，有利于提高肿瘤切除程度及减少手术并发症．手术后辅助放疗有利于改善预后。

Microsurgical Treatment of Medulloblastomas in Children： Report of 24 Cases

BACKGROUND ＆ OBJECTIVE： Medulloblastomas are the most common malignant brain tumors in children. Maximum removal of the tumor is one of most important prognosis factor for medulloblastoma patients. In this study, we summarize the experiences in nfierosurgieal treatment of medulloblastomas in children through analyzing the clinical data of 24 patients with medulloblustoma. METHODS： The clinical data of 24 patients with medulloblastomas in the Department of Neurosurgery, Meizhou Hospital from 1999 to 2007 were reviewed retrospectively. Among 24 patients, 16 were male cand 8 were female, with an average age of 7.5 years old. The frequent symptoms and signs were increased intraeranial pressure and ataxia. All the patients presented with preoperative hydrocephalus. Mierosurgieal resection was undergone in all the patients, followed by radiotherapy Follow-up was achieved in 19. RESULTS： Of the 24 patients, total removal was achieved in 21 eases, subtotal removal in 2 cases and partial removal in 1 case.. The operative mortality rate was 4.2%（1/24）. There was no serious postoperative complication. CONCLUSIONS： Mierosurgieal total removal of medullobastoma is key to the management of medulloblastoma. Mierosurgieal treatment of medulloblastomas in children, followed by radiotherapy improve the prognosis.