Nikolaeva N F
Zh Vopr Neirokhir Im N N Burdenko. 1977 May-Jun(3):28-34.
An analysis of the early postoperative course after tumour removal from the chiasmal-diencephalic area in 156 children aged 2 to 16 years is presented. Acute diencephalic disorders developed after the operation in half the children: in 53--as single diencephalic disorders and in 25--as an acute diencephalic syndrome which was more hazardous. To prevent acute diencephalic disorders glucocorticoid hormones were administered to the patients before and 7 days after the operation; mild hypothermia was applied during the operation and superficial (in some patients) during first three postoperative days; the normal level of temperature was artificially maintained when it tended to hyperthermia. In cases of the acute diencephalic syndrome the complex treatment included antihyperthermal, glucocorticoid, dehydrational and sedative therapy; a sufficient circulatory blood volume and water and electrolytic balance were maintained. In cases of single diencephalic disorders the treatment was conducted depending on the revealing of this or that symptom. The treatment was effective in 78% of patients with single diencephalic disorders and in 30%--with the acute diencephalic syndrome. No effect was mainly connected with hard irreversible organic injuries in the diencephalic area and the brain as a whole.
对156名2至16岁儿童在切除视交叉 - 间脑区域肿瘤后的早期术后病程进行了分析。术后半数儿童出现急性间脑功能障碍：53例为单纯性间脑功能障碍，25例为更危险的急性间脑综合征。为预防急性间脑功能障碍，术前及术后7天给患者使用糖皮质激素；术中采用轻度低温，术后前三天采用体表低温（部分患者）；体温有升高趋势时人工维持正常体温。对于急性间脑综合征患者，综合治疗包括退热、糖皮质激素、脱水和镇静治疗；维持足够的循环血容量及水电解质平衡。对于单纯性间脑功能障碍患者，根据所发现的症状进行治疗。单纯性间脑功能障碍患者中78%的治疗有效，急性间脑综合征患者中30%的治疗有效。治疗无效主要与间脑区域及整个大脑严重的不可逆器质性损伤有关。
