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目的经胼胝体-穹窿间入路的颅咽管瘤儿童认知功能受损的表现与相关危险因素。方法分析2007年1月~2014年6月我院51例经胼胝体穹窿间入路的颅咽管瘤儿童患儿的临床资料,将22例术后出现认知障碍的患儿纳为观察组,将未出现认知障碍的患儿归为对照组。结果观察组患者常识(t=7.134,P<0.001)、算术(t=4.859,P<0.001)、词汇(t=9.176,P<0.001)、领悟(t=3.269,P=0.002)、数字广度(t=4.941,P<0.001)、言语智商(t=7.917,P<0.001)、总智商评分(t=5.895,P<0.001)明显低于对照组,差异具有统计学意义(P<0.05);两组研究对象在年龄(χ~2=4.961,P=0.026)、肿瘤大小(χ~2=4.796,P=0.029)、切除程度(χ~2=4.638,P=0.031)、术后是否放疗水平(χ~2=2.774,P=0.006)比较上差异具有统计学差异(P<0.05)。而在是否存在囊性、钙化水平上无统计学差异(P>0.05);运用Logistic多因素逐步回归分析方法分析经胼胝体穹窿间入路的颅咽管瘤儿童相关因素与认知功能障碍的关系,其中以认知功能障碍为因变量,以年龄、肿瘤大小、是否囊性、是否钙化、切除程度、术后是否放疗因素为自变量,发现年龄、肿瘤大小、切除程度、术后是否放疗是经胼胝体穹窿间入路的颅咽管瘤儿童认知功能受损的独立危险因素。结论采用经胼胝体-穹窿间入路手术可导致颅咽管瘤患儿出现语言及记忆功能的缺失,其中年龄、肿瘤大小、切除程度、术后否放疗是经胼胝体穹窿间入路的颅咽管瘤儿童,是认知功能障碍的独立危险因素。
Objective To investigate the cognitive impairment of children with craniopharyngioma via corpus callosum - vault and related risk factors. Methods The clinical data of 51 children with craniopharyngioma admitted to our hospital from January 2007 to June 2014 were analyzed retrospectively. Twenty-two children with cognitive impairment after operation were included in the observation group, Children without cognitive impairment were classified as control group. Results The common sense of the observation group (t = 7.134, P <0.001), arithmetic (t = 4.859, P <0.001), vocabulary (t = 9.176, (t = 4.941, P <0.001), speech IQ (t = 7.917, P <0.001), total intelligence score (t = 5.895, P <0.001) was significantly lower than that of the control group (Χ ~ 2 = 4.961, P = 0.026), tumor size (χ ~ 2 = 4.796, P = 0.029), degree of resection (χ ~ 2 = 4.638, P = 0.031) Radiotherapy (χ ~ 2 = 2.774, P = 0.006) compared with the difference was statistically significant (P <0.05). (P> 0.05). Logistic regression analysis was used to analyze the relationship between cognitive impairment and related factors in children with craniopharyngioma through the corpus callosum , Of which cognitive impairment as a dependent variable, age, tumor size, cystic, whether calcification, resection degree, postoperative radiotherapy factors as independent variables and found that age, tumor size, degree of resection, postoperative radiotherapy is Independent risk factors of cognitive impairment in children with craniopharyngioma via corpus callosal approach. Conclusions The operation of transcallasal corpus - vault may lead to the loss of language and memory in children with craniopharyngioma. The age, tumor size, degree of resection and postoperative radiotherapy are the craniopharyphas of the corpus callosum Tumor children, is an independent risk factor for cognitive dysfunction.