论文部分内容阅读
本文报告34例儿童和成人(年在26岁以下)颅内髓母细胞瘤。其中儿童26例,占同年龄儿童颅内肿瘤的28.3％,占儿童幕下肿瘤的48.1％。临床表现有1.颅内压增高,如头痛(90.6％)、呕吐(84.5％)、视乳头水肿(84.3％)。2.出现小脑体征的占75％。25例脑室造影均能明确诊断病变部位。在治疗上肿瘤全切除者15例(44.1％),大部切除10例(29.4％),部分切除者8例(23.5％)。手术生存29例(85.2％),死亡5例(14.7％)。经随访的12例中,出院后1及6个月死亡各3例,9个月死亡1例。 虽然肿瘤对放疗敏感,但术前不应使用放疗和化疗,用髓母细胞瘤仅74.4％发生在蚓部。我们认为对于这种肿瘤,应全部切除瘤体为宜,并使硬脑膜开放。这样能使减压充分,脑脊液通畅。术后适当加用放疗和化疗可进一步提高远期效果。
This article reports 34 cases of children and adults (in the 26 years of age) intracranial medulloblastoma. Among them, 26 cases of children, accounting for 28.3% of the same age children with intracranial tumors, accounting for 48.1% of children under the curtain tumor. Clinical manifestations 1. Increased intracranial pressure, such as headache (90.6%), vomiting (84.5%), papilledema (84.3%). 2. Appeared cerebellar signs accounted for 75%. 25 cases of ventricular angiography can confirm the lesion. In the treatment of total tumor resection in 15 cases (44.1%), the majority of resection in 10 cases (29.4%), partial resection in 8 cases (23.5%). Surgical survival in 29 cases (85.2%), death in 5 cases (14.7%). Of the 12 patients who were followed up, 3 died at 1 and 6 months after discharge and 1 died at 9 months. Although the tumor is sensitive to radiotherapy, radiotherapy and chemotherapy should not be used preoperatively, with only 74.4% of medulloblastoma occurring in the vermis. We think that for this tumor, the tumor should be removed entirely appropriate, and the dural opening. This will enable full decompression, cerebrospinal fluid patency. Appropriate treatment with radiotherapy and chemotherapy can further improve the long-term results.