儿童颅咽管瘤患者经胼胝体穹窿间入路手术前后认知功能的变化  

Changes in cognitive function in children with craniopharyngioma before and after incision of the corpus callosum

作　　者：杜鹏程[1] 张海军[1] 郭伟伦[1] 

机构地区：[1]河北省承德市中心医院神经外科,承德067000

出　　处：《中国肿瘤临床与康复》2017年第8期978-981,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨儿童颅咽管瘤患者经胼胝体穹窿间入路手术前后认知功能的变化。方法选取2005年5月至2016年5月间河北省承德市中心医院收治的42例颅咽管瘤患儿,按不同手术方法分为胼胝体穹窿间入路组(22例)和非胼胝体穹窿间入路组(20例),术后6个月时进行认知功能检查,行韦氏儿童智力测试(C-WISC),观察两组患者认知功能情况,并分析颅咽管瘤患儿认知功能的危险因素。结果胼胝体穹窿间入路组患儿的知识、算术、词汇、领悟、图片排列、言语智商(VIQ)和总智商(FIQ)评分均低于非胼胝体穹窿间入路组患儿,差异均有统计学意义(均P<0.05),而两组患儿的图形拼接和操作智商(PIQ)评分比较,差异无统计学意义(P>0.05)。经多因素Logistic回归分析,发现年龄≤7岁、肿瘤直径>4cm、全切除和术后放疗是经胼胝体穹窿间入路手术的颅咽管瘤患儿认知功能的危险因素。结论儿童颅咽管瘤患者术后认知功能受损可能与年龄、肿瘤大小、切除程度和术后有否行放疗有关。Objective To investigate changes in cognitive function in children with craniopharyngi- oma before and after incision of the corpus callosum. Methods A total of 42 children with craniopharyngio- ma treated at Chengde Central Hospital from May 2015 to May 2016 were selected. According to surgical methods, patients were divided into the incision through corpus callosum group （22 patients） and non-inci- sion through corpus callosum group （20 patients）. At 6 months after the operation, cognitive function test was performed. Wechsler child intelligence test （C-WISC） was used to observe the cognitive function in the two groups, and risk factors were analyzed. Results Knowledge, arithmetic, vocabulaqT, comprehen- sion, picture arrangement, verbal intelligence quotient （VIQ） and full-scale intelligence quotient （ FIQ ） scores were lower in incision through corpus callosum group than in non-incision through corpus callosum group （ all P 〈 0. 05 ）. However, there was no significant difference in graphic stitching and performance IQ （ P 〉 0. 05 ）. Multivariate logistic regression analysis revealed that the age 〈7 years old, tumor diameter 〉 4 cm, total resection and postoperative radiotherapy were risk factors for cognitive impairment in children with craniopharyngioma undergoing incision of the corpus callosum. Conclusion Cognitive impairment in chil- dren with craniopharyngioma may be related to age, tumor size, the degree of resection and postoperative ra- diotherapy.

关 键 词：儿童 颅咽管瘤 经胼胝体穹窿间入路手术 认知功能 

分 类 号：R739.41[医药卫生—肿瘤]