小脑囊实性肿瘤诊治分析

doi:10.3969/j.issn.1005-6483.2019.07.014

摘要/Abstract

摘要： 目的：分析不同年龄段小脑囊实性肿瘤的病理类型、手术切除程度和治疗效果等。方法：影像学表现为小脑囊实性肿瘤病人68例，按照年龄分为青少年组36例（年龄＜18岁）和成年组32例（年龄≥18岁）。根据肿瘤大小和部位选择枕下正中或旁正中入路肿瘤切除术。分析统计两组病人病理类型、手术全切率、并发症发生率和治愈率。结果：青少年组以毛细胞星形细胞瘤多见（20例，55.5%），成年组主要是血管母细胞瘤（13例，40.6%），两组比较差异有统计学意义（P＜0.05）。成年组髓母细胞瘤手术全切率（22.2%）及治疗有效率（33.3%）均低于青少年组（50.0%和44.4%）。两组毛细胞星形细胞瘤及血管母细胞瘤手术全切率均为100%，青少年组毛细胞星形细胞瘤治愈率94.7%，而成年组血管母细胞瘤治愈率为81.8%。两组术后并发症发生率无显著差别。结论：小脑囊实性肿瘤在青少年病人中以毛细胞星形细胞瘤多见，成年病人中以血管母细胞瘤为多；两组毛细胞星形细胞瘤及血管母细胞瘤手术全切率高，术后疗效好，而髓母细胞瘤病人手术全切率低，预后较差。

关键词: cerebellum tumor, solid cystic tumor, medulloblastoma, surgery

Abstract: Objective：To analyze the clinical features，the extent of tumor removal and the prognosis of patients of cerebellum solidcystic tumors in different age groups.Methods：The clinical datas of 68 cases of cerebellum solidcystic tumors with MRI was retrospectively analyzed.Patients younger than 18yearold or 18yearold were grouped into the adolescent group and patients older than 18yearold were grouped into the adult group.Results：The predominant pathological type of tumors was pilocytic astrocytoma（PA）（n=20，55.5%）in adolescent group，and hemangioblastoma（HB）（n=13，40.6%）in adult group（χ2=28.69，P＜0.01）.Additionally，tumor resection rate and curative rate of medulloblastoma（22.2% and 33.3%）in adult group was lower than those in adolescent group（50.5% and 44.4%）.The 100% of total tumor resection rate of PA and HB was demonstrated in adolescent group and adult group，however，tumor curative rate of PA in adolescent group was 94.7% and of HB in adult group was 81.8%.No statistical difference of occurrence rate of postoperational complications was detected in these two groups.Conclusion：The predominant pathological type of tumors was PA in adolescent group and HB in adult group.Patients with PA and HB have a high resection rate and a good prognosis.However，the total medulloblastoma resection rate of adult and adolescent patients was low and the prognosis was even worse.

Key words: cerebellum tumor, solid cystic tumor, medulloblastoma, surgery

孙道法, 尧小龙, 王俊文等. 小脑囊实性肿瘤诊治分析[J]. 临床外科杂志, 2019, 27(7): 585-588.

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