第三脑室造瘘术对后颅窝肿瘤伴脑积水患儿肿瘤切除术后神经功能的影响  

Effect of third ventriculostomy on neurological function in children with posterior fossa tumor and hydrocephalus after tumor resection

作　　者：李娜 LI Na(Department of Neurosurgery,Children's Hospital of Nanjing Medical University,Nanjing,Jiangsu 210000,China)

机构地区：[1]南京医科大学附属儿童医院神经外科,江苏南京210000

出　　处：《中国优生与遗传杂志》2021年第7期970-973,共4页Chinese Journal of Birth Health & Heredity

摘　　要：目的探究神经内镜下第三脑室造瘘术(ETV)对后颅窝肿瘤伴脑积水患儿肿瘤切除术后神经功能的影响。方法回顾性选择2017年2月—2019年2月本院收治的40例确诊为后颅窝肿瘤伴脑积水的患儿作为研究对象,根据肿瘤切除术前应用治疗方法的不同,分为研究组20例,对照组20例。其中研究组接受ETV治疗,对照组接受脑室-腹腔分流术治疗,之后两组患者均在同期行肿瘤切除术。比较两组治疗有效率,术前、术后炎症因子水平、神经功能改善情况,计算术后并发症发生率。结果研究组治疗有效率[95.00%(19/20)]显著高于对照组[70.00%(14/20)],比较差异具有统计学意义(χ^(2)=4.329,P<0.05)。术后,两组患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、S100β蛋白水平及美国国立卫生研究院卒中量表(NIHSS)评分均比术前明显降低(P<0.05);且术后研究组血清TNF-α、IL-6、S100β蛋白水平及NIHSS评分均显著低于对照组(P<0.05)。研究组术后并发症发生率10.00%远低于对照组40.00%,两组比较差异具有统计学意义(P<0.05)。结论第三脑室造瘘术治疗后颅窝肿瘤伴脑积水患儿有效率高,能有效降低肿瘤切除术后机体炎症水平,改善患者神经功能,且术后并发症少。Objective To investigate the effect of endoscopic third ventriculostomy(ETV) on neurological function of children with posterior fossa tumor and hydrocephalus after tumor resection. Methods From February 2017 to February 2019, 40 children with posterior fossa tumor and hydrocephalus were selected as the research objects. According to the different treatment methods before tumor resection, they were divided into study group(20 cases) and control group(20 cases).The study group received ETV treatment, while the control group received ventriculo-peritoneal shunt. After that, the two groups of patients underwent tumor resection at the same time. The effective rate of the two groups, the level of inflammatory factors before and after operation, the improvement of neurological function was compared between the two groups, and the incidence of postoperative complications was calculated. Results The effective rate of the study group was 95.00%(19/20),which was significantly higher than that of the control group(70.00%, 14/20), and the difference was statistically significant(χ^(2)=4.329, P<0.05). After operation, the levels of serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), S100 β protein and National Institutes of Health stroke scale(NIHSS) score in the two groups were significantly lower than those before operation(P<0.05);and the levels of serum TNF-α, IL-6, S100 β protein and NIHSS score in the study group were significantly lower than those in the control group(P<0.05). The incidence of postoperative complications in the study group(10.00%) was significantly lower than that in the control group(40.00%)(P<0.05). Conclusion The third ventriculostomy in the treatment of posterior fossa tumor with hydrocephalus has a high effective rate, it can effectively reduce the level of inflammation after tumor resection, improve the neurological function of patients, and has less postoperative complications.

关 键 词：第三脑室造瘘术 后颅窝肿瘤伴脑积水 神经功能 

分 类 号：R651.1[医药卫生—外科学]