儿童后颅窝肿瘤围术期并发症危险因素分析  

Analysis of risk factors for perioperative complications in pediatric posterior fossa tumors

作　　者：王举磊 黄涛 张韫泽 田启龙 杨晨 屈延 WANG Julei;HUANG Tao;ZHANG Yunze;TIAN Qilong;YANG Chen;QU Yan(Department of Neurosurgery,Tangdu Hospital,Air Force 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：《空军军医大学学报》2025年第3期362-365,371,共5页Journal of Air Force Medical University

基　　金：陕西省重点研发计划一般项目(2019-SF058)。

摘　　要：目的分析儿童后颅窝肿瘤手术后的围术期并发症,并确定相关的危险因素。方法回顾性分析2017年1月至2023年8月间在空军军医大学唐都医院神经外科接受手术切除后颅窝肿瘤的患儿临床资料。收集数据包括年龄、临床表现、肿瘤位置、术前是否继发脑积水、手术时机、手术入路、手术团队、手术切除程度、围术期并发症和组织病理学诊断,统计分析所得数据与围术期并发症的相关性。结果共纳入144例患儿。48例患儿出现围术期并发症,并发症发生率为33.3%,其中14例需要干预,围术期死亡1例,死亡率为0.7%。在单因素分析中,肿瘤体积和位置、枕下后正中入路及联合入路与并发症发生率增加有统计学相关性(P<0.05)。肿瘤组织病理类型、切除范围和术前是否继发脑积水与围术期并发症无显著相关。多变量分析结果显示,中线肿瘤、肿瘤体积>113 cm^(3)(直径>3 cm)以及由非小儿神经外科专科医生进行手术是独立的危险因素(P<0.05)。结论儿童后颅窝肿瘤切除手术在围术期具有较高的并发症发生风险,明确相关危险因素有助于制定更加精准的手术方案,改善围术期治疗方案可降低并发症发生率。Objective To analyze perioperative complications following surgery for posterior fossa tumors in children and to identify associated risk factors.Methods The clinical data of children who underwent surgical resection of posterior cranial fossa tumors in Department of Neurosurgery,Tangdu Hospital,Air Force Medical University from January 2017 to August 2023 were retrospectively analyzed.The data collected included age,clinical manifestations,tumor location,preoperative secondary hydrocephalus,operation timing,surgical approach,surgical team,surgical resection degree,perioperative complications and histopathological diagnosis,and statistical analysis of the correlation between the data obtained and perioperative complications.Results A total of 144 children were included.Perioperative complications occurred in 48 patients,the complication rate was 33.3%,of which 14 cases required intervention,and 1 case died during perioperative period,with a mortality rate of 0.7%.In univariate analysis,tumor volume and location,suboccipital posterior median approach,and combined approach were statistically associated with increased complication rates(P<0.05).There was no significant correlation between the pathological type of tumor tissue,the scope of resection and whether there was secondary hydrocephalus before operation and perioperative complications.Multivariate analysis showed that midline tumor,and tumor volume>113 cm^(3)(diameter>3 cm)and surgery by a non-pediatric neurosurgeon were independent risk factors(P<0.05).Conclusion Posterior fossa tumor resection in children has a higher risk of complications during the perioperative period.The identification of relevant risk factors is helpful to develop more accurate surgical plans,improve perioperative treatment plans,and reduce the incidence of complications.

关 键 词：儿童 后颅窝肿瘤 围术期并发症 危险因素 

分 类 号：R739.4[医药卫生—肿瘤]