儿童后颅窝中线肿瘤术后脑积水的原因及其防治  

Postoperative hydrocephalus in children with posterior fossa tumors involving the midline: risk factors and prevention

作　　者：王翦[1] 杨宏[1] 梁建民[1] 陈晞[1] 

机构地区：[1]广州医学院第二附属医院神经外科,广州510260

出　　处：《广东医学》2011年第11期1380-1382,共3页Guangdong Medical Journal

摘　　要：目的探讨儿童后颅窝中线肿瘤术后脑积水的成因及其防治方法。方法回顾性分析87例儿童后颅窝中线肿瘤术前与术后脑积水变化及其影响因素。结果肿瘤全切率85.1%,病死率2.3%。术后需手术治疗的脑积水共14例(16.1%),其中7例(8.0%)重度脑积水患儿于术后6周内行脑室-腹腔分流术(VPS)。7例(8.0%)于术后2～35个月内行脑室镜下第三脑室底造瘘术(ETV)或VPS。术后需手术治疗脑积水的患儿中,平均年龄(4.6±1.6)岁,其中室管膜瘤8例,髓母细胞瘤4例,星形细胞瘤2例。结论后颅窝肿瘤切除前行VPS或ETV不应作为常规治疗方法。术后脑积水与患儿年龄、肿瘤病理和手术操作密切相关,适当的治疗方法可降低术后脑积水的发生率,避免二次手术。Objective To investigate the causes and prevention of postoperative hydrocephalus in children with posterior fossa tumors. Methods Data of 87 children with posterior fossa tumor were retrospectively reviewed. The pre - and post - operative hydrocephalus were compared and analyzed. Results Total removed rate of tumor was 85.1% , with mortality of 2. 3%. Permanent cerebrospinal fluid （CSF） diversion was reqired in 14 cases （16. 1% ）, with averaged age of （4. 6 ±1.6） years, among which 7 cases （ 8.0% ） received ventriculoperitoneal shunting （VPS） in 6 weeks and VPS or endoscopic third ventriculostomy （ETV） 2 -35 months after surgery. Postoperative hydrocephalus requiring surgery treatment was revealed in 8, 4 and 2 cases with ependymoma, medulloblastoma and astrocytoma, respectively. Conclusion Pre -rectional VPS and ETV are not necessary for the children with posterior fossa tumors. Age of surgery, pathology of the tumor and extension of tumor resection were significantly associated with definitive postoperative CSF diversion.

关 键 词：后颅窝 中线 肿瘤 手术 脑积水 

分 类 号：R651.150.6[医药卫生—外科学]