儿童颅咽管瘤不同手术入路效果及其术后死亡相关因素分析
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摘要
目的探讨儿童颅咽管瘤不同手术入路效果及其术后死亡相关因素分析。方法回顾性分析69例颅咽管癌患儿资料,根据手术入路不同,分为三组,A组(翼点入路)、B组(纵裂-终板入路)、C组(额底-纵裂入路)。对比三组肿瘤切除情况、术后主要并发症、术后死亡率及分析颅咽管瘤患儿术后死亡危险因素。结果三组切除程度、钠代谢紊乱、尿崩症发生率对比,差异无统计学意义,P> 0.05。三组术后死亡率对比无统计学意义,P> 0.05。术后死亡相关因素分析结果显示,高热、严重下丘脑损伤、电解质紊乱、肿瘤切除程度是影响儿童颅咽管瘤术后死亡的危险因素。结论翼点入路、纵裂-终板入路、额底-纵裂入路3种入路手术效果相当,术后高热、严重下丘脑损伤、电解质紊乱情况及肿瘤切除程度是儿童颅咽管瘤术后死亡的高危因素。
Objective To investigate the efficacy of different surgical approaches in craniopharyngioma and the postoperative death related factors analysis.Methods 69 cases with craniopharyngioma data were collected,who were divided into three groups,A group( pterion approach),B group( Longitudinal split-end plate approach) and C group( Frontal-longitudinal split approach).The tumor resection,major postoperative complications,postoperative mortality of three groups were compared,the postoperative death related factors were analyzed.Results The resection degree,Sodium metabolism disorder,the incidence of diabetes,postoperative mortality of three groups had no significant difference,P > 0.05.The high fever,severe hypothalamus injury,electrolyte disturbance,tumor resection degree were risk factors in craniopharyngioma.Conclusion Pterion approach,longitudinal split-end plate approach and frontal-longitudinal split approach of three groups had similar efficacy,the high fever,severe hypothalamus injury,electrolyte disturbance,tumor resection degree were risk factors in craniopharyngioma in postoperative.
Objective To investigate the efficacy of different surgical approaches in craniopharyngioma and the postoperative death related factors analysis.Methods 69 cases with craniopharyngioma data were collected,who were divided into three groups,A group( pterion approach),B group( Longitudinal split-end plate approach) and C group( Frontal-longitudinal split approach).The tumor resection,major postoperative complications,postoperative mortality of three groups were compared,the postoperative death related factors were analyzed.Results The resection degree,Sodium metabolism disorder,the incidence of diabetes,postoperative mortality of three groups had no significant difference,P > 0.05.The high fever,severe hypothalamus injury,electrolyte disturbance,tumor resection degree were risk factors in craniopharyngioma.Conclusion Pterion approach,longitudinal split-end plate approach and frontal-longitudinal split approach of three groups had similar efficacy,the high fever,severe hypothalamus injury,electrolyte disturbance,tumor resection degree were risk factors in craniopharyngioma in postoperative.
引文
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[3]程荆,江普查,曹长军,等.颅咽管瘤显微手术的疗效分析[J].中国临床神经外科杂志,2016,21(1):1-3.
[4]秦至臻,王建祯,马振宇,等.颅咽管瘤显微手术治疗及疗效分析[J].武警医学,2017,28(1):51-53.
[5]唐斌,谢申浩,周东伟,等.神经内镜经鼻入路切除颅咽管瘤的手术经验[J].中华神经外科杂志,2017,33(11):1094-1097.
[6]王小永,林松,于洮,等.颅咽管瘤术后水电解质变化趋势及其影响因素分析[J].中国临床医生杂志,2016,44(5):63-66.
[7]周凯,范雁东,吴鹏飞,等.内镜下经鼻蝶入路术治疗颅咽管瘤疗效及其对巨噬细胞炎性蛋白-1α、IL-6、IL-8的影响[J].疑难病杂志,2017,16(11):1089-1092.
[8]石祥恩,周忠清,吴斌,等.颅咽管瘤切除术与下丘脑功能保护(附1182例报告)[J].中华神经外科杂志,2017,33(11):1107-1112.
[9]夏志强,杜彦挺,杜光勇,等.颅咽管瘤中IL~1α、IL~6的表达的临床意义[J].中南医学科学杂志,2016,44(5):564-567.
[10]唐斌,谢申浩,黄观林,等.神经内镜下扩大经鼻入路切除复发颅咽管瘤[J].中华神经外科杂志,2017,33(10):985-989.