儿童第三脑室颅咽管瘤术后并发症的防治策略

目的 分析经胼胝体-穹窿间入路显微手术切除儿童第三脑室颅咽管瘤术后并发症并探讨其正确的处理措施.方法 回顾性分析26例经胼胝体-穹窿间入路切除儿童第三脑室颅咽管瘤术后出现的并发症及其处理方法.结果 全组患者术后均出现了不同程度的各种并发症,其中尿崩症24例,高钠高氯血症22例,低钠血症18例,高热12例,脑窜感染3例,癫痢大发作2例.临床痊愈出院16例,好转出院10例,未出现死亡病例.结论 术后严密监测血电解质及尿量、甲状腺功能及血清皮质醇;手术前后补充糖皮质激素、术后补充甲状腺素,积极处理尿崩症和电解质紊乱、高热、脑室感染等并发症,具有与手术本身同样的重要性.

Prevention and treatment of postoperative complications for the third ventricle pediatric craniopharyngioma

Objective To analyze the postoperative complications of mierosnrgical resection of the third pediatric craniopharyngioma in childern and discuss correct prevention and therapeutic methods. Methods The postoperative complications and their treatments of 26 children with the the third ventricle pediatric craniopharyngioma underwent microneurosurgical resection through transcallosal-interfornix approach were analyzed retrospectively. Results Among 26 patients after operation, 24 suffered from diabetes insipidus, 22 hypernatremia and hyperchloraemia. 18hyponatremia, 12 lyperpyrexia, 3 ventricular infection, 2 epilepsy and convulsion attacks. Of 26 patients, 16 recovered clinically, lO improved and no postoperative death. Conclusion Monitoring the serum electrolyte disorder and the urine volume, thyroid function, serum cortisol strictly after operation, giving glucocorticoid pre-and post-operatively, giving thyroid hormone post-operation, active treatment of complications, such as diabetes insipidus and serum electrolyte disorder, hyperpyrexia, ventricnlar infection and etc. are of the same importance as microsurgieal technique, will help patients to recover.