显微外科治疗儿童下丘脑胶质瘤

目的 探讨儿童下丘脑胶质瘤的显微外科治疗方法和术后并发症的处理。方法 根据肿瘤的部位、大小和生长方向进行临床分型，分别采用经肼胝体—弯窿间入路及经纵裂、经额下入路，对21例儿童下丘脑胶质瘤进行显微外科手术治疗。结果 21例儿童下丘脑胶质瘤均经手术和病理证实，肿瘤全切除和近全切除18例，大部分切除3例，术后无死亡病例。主要并发症有下丘脑损伤所致的尿崩、电解质紊乱、高热，手术并发症有硬膜下积液、脑积水、癫痫，均经相应治疗治愈。17例获得随访，16例能正常生活。结论 对儿童下丘脑胶质瘤选择适当的手术入路进行显微外科手术和积极治疗术后并发症是提高疗效的重要方法。

Microsurgical treatment of hypothalamic gliomas in children

Objective To evaluate the efficiency of microsurgical methods for treatment of hypothalamic gliomas in children and the management of postoperative complications Methods Twenty-one tumors were classified into two types according to their location, size and extensive direction The tumors were removed with microsurgical technique by various approaches, such as transcallosal-interforniceal or translongitudinal fissure, transubfrontal methods Results Twenty-one cases of hypothalamic gliomas were verified by surgery and pathology The total and subtotal removal was 18 cases Partial removal was 3 cases There was no mortality in this series Major neurological complications included diabetes insipidus, electrolyte disorder and hyperthermia Surgical complications included subdural fluid collections, hydrocephalus, epilepsy Seventeen cases were followed up, and showed satisfying results Conclusion Microsurgical operations through appropriate approaches and reasonable management of complications are important methods for improving the outcome of hypothalamic gliomas in children