摘要：

目的: 总结儿童颅咽管瘤手术治疗效果及长期生活质量。方法: 选择2014年3月至2024年6月在首都医科大学宣武医院行肿瘤切除术的30例颅咽管瘤患儿，回顾分析其术前、手术过程中及随访相关资料，以Katz指数、肥胖、回归正常学校生活和参加学校体育运动为主要指标随访其长期生活质量。结果: 术前达肥胖标准者7例（23.33%）；存在内分泌功能障碍者19例（63.33%）；30例（100%）Katz指数均为A级。手术全切除29例（96.67%），次全切除1例（3.33%）。随访时间为38.00（17.25，53.00）个月，末次随访时达肥胖标准者增至9例（30%），手术前后差异无统计学意义（χ²=0.125，P=0.727）；末次随访时存在内分泌功能障碍者增至27例（90%），手术前后差异有统计学意义（χ²=4.083，P=0.039）；30例（100%）Katz指数仍为A级。末次随访时仅1例（3.33%）肿瘤全切除手术后未能回归正常学校生活，2例（6.67%）肿瘤全切除手术后因存在一定程度运动功能下降无法参加学校体育运动。结论: 儿童颅咽管瘤患者手术后可获得良好预后，仍是需要追求的手术治疗目标。

关键词: 颅咽管瘤, 神经外科手术, 生活质量, 儿童

Abstract:

Objective: To review the effect of resection of pediaric craniopharyngioma and the long-term quality of life. Methods: The clinical datas before, during and after operation of 30 pediatric craniopharyngioma patients who were operated in Xuanwu Hospital, Capital Medical University from March 2014 to June 2024 were collected for retrospective analysis. The Katz index, body mass index (BMI), as well as one's ability to paparticipate in normal school life and physical exercise at last follow-up were recorded as key factors of long-term quality of life assesement. Results: There were 7 (23.33%) of pediatric craniopharyngioma patients were identified as obese, 19 (63.33%) patients had endocrine dysfunction and 30 (100%) were identified as Katz index grade A before operation. Total resection of the tumor was achieved in 29 cases, while one case had subtotal resection. Median follow-up time was 38.00 (17.25, 53.00) months. The number of obese children increased to 9 (30%) during the last follow-up, but showed no statistic significance (χ² = 0.125, P = 0.727). The number of patients with endocrine dysfunction increased to 27 (90%), and showed statistic significance (χ² = 4.083, P = 0.039). All 30 cases remained Katz index grade A during the last follow-up. During the last follow-up, only one patient hadn't return to normal school life and 2 patients couldn't join physical exercise in school after total resection of craniopharyngioma. Conclusions: Total resection in pediatric craniopharyngioma patients can still achieve good prognosis, and should be the target of surgical treatment.

Key words: Craniopharyngioma, Neurosurgical procedures, Quality of life, Child