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目的探讨儿童颅后窝肿瘤术后缄默症的临床特点及溴隐亭合并美多巴对其的疗效。方法 回顾性分析儿童颅后窝肿瘤术后缄默症31例,比较16例接受溴隐亭合并美多巴治疗的术后缄默症患儿与15例未接受治疗者的病程,观察治疗组16例中8例患儿药物中途撤除溴隐亭对疗效的影响。结果31例缄默症全部为颅后窝位于中线的大肿瘤全切术后,肿瘤病理类型为:髓母细胞瘤21例,星形细胞瘤7例,室管膜瘤3例。术后出现缄默症的时间为0～4天(平均1.2天),治疗组病程2～15天(平均11天),明显低于对照组9～80天(平均39天)。治疗组中8例于开始说话后第3天将溴隐亭减至原用量的1/3,均于减量次日重新出现缄默症状。随溴隐亭剂量再次增加,8例病人症状均逐渐好转直至重新开始说话。结论 儿童颅后窝中线大肿瘤全切术后易出现缄默症,有一定潜伏期,持续时间短暂,溴隐亭合并美多巴口服可明显缩短其病程。
Objective To investigate the clinical features of postoperative mutagenesis in children with posterior fossa tumors and the efficacy of bromocriptine combined with meridoban. Methods A retrospective analysis of 31 cases of postoperative mutagenesis in children with posterior fossa tumors of the skull was performed. The duration of postoperative mutism and 16 cases of untreated patients receiving bromocriptine combined with methyldopa were compared. 16 cases in the treatment group In 8 cases of children with drug removal of bromocriptine halfway effect. Results Totally 31 cases of mutational disease were all resected in the large tumor with posterior fossa posterior midline. The tumor pathological types were 21 cases of medulloblastoma, 7 cases of astrocytoma and 3 cases of ependymoma. The duration of postoperative morbidity was 0 to 4 days (mean, 1.2 days). The duration of treatment in the treatment group ranged from 2 to 15 days (mean, 11 days), significantly lower than that of the control group, ranging from 9 to 80 days (mean, 39 days). Treatment group, 8 patients began to speak after the first 3 days of bromocriptine reduced to the original amount of 1/3, were re-appeared in the next day after the reduction of silent symptoms. With the dose of bromocriptine once again increased, the symptoms of 8 patients gradually improved until they began to speak again. Conclusion Children with posterior fossa posterior midline large tumor resection prone to mutagenesis, have a certain incubation period, the duration of transient, bromocriptine combined with mededopa oral can significantly shorten the course.