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目的探讨儿童颅咽管瘤患者经胼胝体穹窿间入路手术前后认知功能的变化。方法选取2005年5月至2016年5月间河北省承德市中心医院收治的42例颅咽管瘤患儿,按不同手术方法分为胼胝体穹窿间入路组(22例)和非胼胝体穹窿间入路组(20例),术后6个月时进行认知功能检查,行韦氏儿童智力测试(C-WISC),观察两组患者认知功能情况,并分析颅咽管瘤患儿认知功能的危险因素。结果胼胝体穹窿间入路组患儿的知识、算术、词汇、领悟、图片排列、言语智商(VIQ)和总智商(FIQ)评分均低于非胼胝体穹窿间入路组患儿,差异均有统计学意义(均P<0.05),而两组患儿的图形拼接和操作智商(PIQ)评分比较,差异无统计学意义(P>0.05)。经多因素Logistic回归分析,发现年龄≤7岁、肿瘤直径>4cm、全切除和术后放疗是经胼胝体穹窿间入路手术的颅咽管瘤患儿认知功能的危险因素。结论儿童颅咽管瘤患者术后认知功能受损可能与年龄、肿瘤大小、切除程度和术后有否行放疗有关。
Objective To investigate the changes of cognitive function in children with craniopharyngioma before and after operation through the corpus callosum. Methods Forty-two patients with craniopharyngioma admitted to Chengde Central Hospital of Hebei Province from May 2005 to May 2016 were divided into corpus callosal vault approach group (n = 22) and non-corpus callosal space (20 cases). Six months after the operation, cognitive function tests and C-WISC were performed to observe the cognitive function of the two groups. The children with craniopharyngioma Knowledge of risk factors. Results The scores of knowledge, arithmetic, vocabulary, comprehension, image rankings, speech IQ (IQQI) and total intelligence (FIQ) score of children in the corpus callosum group were lower than those in the non-corpus callosalium group (P <0.05). There was no significant difference between the two groups in the PI and PQ scores (P> 0.05). Logistic regression analysis showed that age ≤7 years and tumor diameter> 4cm, total resection and postoperative radiotherapy were risk factors of cognitive function in children with craniopharyngioma undergoing corpus callosal approach. Conclusion The cognitive impairment in children with craniopharyngioma may be related to the age, tumor size, degree of resection and postoperative radiotherapy or not.