扩大经蝶入路切除儿童颅咽管瘤临床分析  

Extended transsphenoidal approach for pediatric craniopharyngioma: a clinical analysis

作　　者：王举磊 衡立君 张治国 黄涛 田启龙 屈延 WANG Julei;HENG Lijun;ZHANG Zhiguo;HUANG Tao;TIAN Qilong;QU Yan(Department of Neurosurgery, Tangdu Hospital, Air Force Military Medical University, Xi＇ an 710038, China)

机构地区：[1]空军军医大学唐都医院神经外科,陕西西安710038

出　　处：《中华神经外科疾病研究杂志》2018年第3期216-218,共3页Chinese Journal of Neurosurgical Disease Research

摘　　要：目的探讨扩大经蝶入路切除儿童颅咽管瘤的手术适应症、手术技巧及注意事项。方法回顾性分析采用扩大经蝶入路手术的6例儿童颅咽管瘤患儿的临床资料,包括临床症状、影像、并发症及随访资料等。结果 6例患儿平均年龄10.7岁,均经CT及MRI确诊,主要临床症状为:头痛、视力下降,发育迟缓等。术后5例原发、1例复发性肿瘤均做到内镜下完全切除,无死亡病例。术后近期脑脊液漏1例,颅内感染1例,垂体功能低下2例,尿崩3例。远期(>1个月)垂体功能低下1例,尿崩1例,无复发病例。结论扩大经蝶入路切除儿童颅咽管瘤临床可行,但需要较高的手术技巧及较长时间的学习曲线。鞍膈下型颅咽管瘤为最佳手术适应症。Objective The indications,operative techniques and precautions of extended transsphenoidal approach for pediatric craniopharyngioma were studied.Methods The clinical data of 6 cases with craniopharyngioma who operated via extended transsphenoidal approach were analyzed retrospectively,including the clinical symptoms,images,complications and the follow-up data.Results The average age of 6 cases was 10.7 years old,and all of them were diagnosed by CT and MRI.The main clinical symptoms were headache,decreased vision,and retardation.After operation,5 primary and 1 recurrent tumors were completely resected without death.Postoperative cerebrospinal fluid leakage occurred in 1 case,intracranial infection in 1 case,hypopituitarism in 2 cases and diabetes insipidus in 3 cases.There were 1 case of hypopituitarism,1 case of diabetes insipidus and no recurrence cases within a long term （＞ 1 month）.Conclusion Extended transsphenoidal approach for the removal of pediatric craniopharyngioma is feasible,but it requires a higher surgical skill and a longer learning curve.Craniopharyngioma under the sellar diaphragm is the best surgical indication.

关 键 词：扩大经蝶入路 颅咽管瘤 儿童 

分 类 号：R739[医药卫生—肿瘤]