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[小儿幕上和幕下颅内肿瘤的临床表现]

[Clinical presentation of supratentorial and infratentorial intracranial tumors in pediatric patients].

作者信息

Sánchez-Sánchez Luz María, Vázquez-Moreno Javier, Heredia-Delgado José Antonio, Sevilla-Castillo Ricardo

机构信息

Departamento de Pediatría, UMAE No. 25, Monterrey, N.L., México.

出版信息

Gac Med Mex. 2016 Mar-Apr;152(2):158-62.

Abstract

BACKGROUND

Brain tumors are the second most common malignancy in childhood and they are also the most common solid tumors in children and the most frequent cause of morbidity and mortality associated with cancer in this age.

OBJECTIVE

To determine the clinical presentation of supratentorial and infratentorial intracranial tumors in pediatric patients.

MATERIAL AND METHODS

An observational, retrospective, cross-sectional comparative study in which records the clinical manifestations of 51 pediatric patients diagnosed with intracranial tumor, according with its location, supra- or infratentorial.

RESULTS

51 patients were analyzed. Tumor location was infratentorial in 32 patients (62.7%) and supratentorial in 19 (37.3%). Cerebellar syndrome occurred in 21 patients (65.6 %) with infratentorial tumor compared with six (31.5 %) with supratentorial tumor (p = 0.04; OR: 3.2; 95% CI: 1.1-12.8). Nystagmus was significantly more common in patients with infratentorial tumors (p = 0.029). Endocrine manifestations were present in four patients (21%) with supratentorial tumor and none of the infratentorial group (p = 0.03).

CONCLUSIONS

Cerebellar syndrome was statistically significantly more common in patients with infratentorial when compared with patients with supratentorial. Nystagmus is one of the most common visual impairments in patients with infratentorial tumor. Endocrine disorders are significantly more frequent in patients with supratentorial tumor. The interval between onset of symptoms and diagnosis of intracranial tumor is significantly longer in children with supratentorial tumor because the symptoms are more insidious in onset and are mistaken for other benign conditions.

摘要

背景

脑肿瘤是儿童期第二常见的恶性肿瘤,也是儿童最常见的实体瘤,并且是该年龄段与癌症相关的发病和死亡的最常见原因。

目的

确定小儿患者幕上和幕下颅内肿瘤的临床表现。

材料与方法

一项观察性、回顾性、横断面比较研究,记录了51例被诊断为颅内肿瘤的小儿患者的临床表现,并根据肿瘤位置分为幕上或幕下。

结果

分析了51例患者。肿瘤位于幕下的有32例(62.7%),幕上的有19例(37.3%)。幕下肿瘤患者中有21例(65.6%)出现小脑综合征,而幕上肿瘤患者中有6例(31.5%)出现小脑综合征(p = 0.04;OR:3.2;95% CI:1.1 - 12.8)。眼球震颤在幕下肿瘤患者中明显更常见(p = 0.029)。幕上肿瘤患者中有4例(21%)出现内分泌表现,幕下组无一例出现(p = 0.03)。

结论

与幕上肿瘤患者相比,幕下肿瘤患者的小脑综合征在统计学上明显更常见。眼球震颤是幕下肿瘤患者最常见的视觉障碍之一。幕上肿瘤患者的内分泌紊乱明显更频繁。幕上肿瘤患儿从症状出现到颅内肿瘤诊断的间隔时间明显更长,因为症状起病更隐匿,易被误诊为其他良性疾病。

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