婴幼儿颅内肿瘤的临床特点及疗效

目的 探讨婴幼儿颅内肿瘤的治疗方法。方法 回顾性分析了114例婴幼儿颅内肿瘤的临床特点及疗效。所有患儿均经显微手术治疗,肿瘤全切除72．0％,近全切除17．5％,大部切除10．5％。对年龄接近或达到3岁的部分患儿建议其术后进行放射治疗。随访时间13个月至7年。结果 肿瘤发生部位依次为：后颅凹37．7％,鞍区31．6％,半球(底节)19．3％。呕吐、头痛、共济失调及视力下降为常见症状。手术死亡1例,其他患儿术后效果较好。随访了86例患儿,20例死亡,66例存活,但有6例发育较同龄儿童差。结论 胚胎性肿瘤、室管膜肿瘤单纯手术预后不好,放射治疗可以抑制肿瘤的生长,对婴幼儿应减少放射剂量,同时要考虑远期并发症。术后化疗可能是今后治疗的方向。星形细胞瘤、少突胶质细胞瘤、混合性胶质瘤全切除后预后良好,不需要进行辅助性治疗。

The clinical features and treatment of intracranial tumors in infants

Objective To explore the treatment plan of intracranial tumors in infants. Methods The clinical features and curative effect of 114 patients of intracranial tumors in infants who were admitted and performed microsurgery were analyzed retrospectively. The total removal of tumor was 72. 0% , subtotal removal 17. 5% , partial removal 10. 5%. The patients of 3 years old or so were advised to perform radiotherapy after operation. Follow-up ranges from 13 months to 7 years. Results The tumor located at posterior fossa ( 37. 7% ) , sella region ( 31. 6% ) , hemisphere ( 19. 3% ) including in basal ganglia. The common symptoms included headache, vomiting, ataxia, and decrease of visual acuity. All the patients obtained good recovery except one patient dead after operation. Among 86 follow-up cases, 20 patients deceased and 66 patients survived. But 6 patients developed worse than the children of the same age. Conclusion Good prognosis can not be obtained for embryonal tumors and ependymoma through operation only. Although radiotherapy is useful of inhibiting the growth of tumor, the dosage should be decreased for infants and the complications in long term also should be considered simultaneously. It is a trend towards performing chemotherapy after operation. It is not necessary to perform auxiliary therapy for astrocytoma, oligodendroglioma, and mixed glioma, because the prognosis is good after total removal of the tumor.