| Objective : By analyzing the data of the post operation , like the age , gender , tumor size and different operation types of the patients and contrasting with the domestic dissertations about the third ventricle tumor in the same period , studying the influence from them to the occurring rates of postoperative hypothalamus dysfunction , to accumulate the experience on the treatment , to summarize the status of third ventricle tumor in our town , to enhance the treatment level ,to decrease postoperative complications ,and to lower the operative mortality .Methods : Study the clinical records of 122 patients who have been diagnosed as the third ventricle tumor and got microsurgery treatment in our hospital from January 1st 2003 to October 31st 2008 . First of all, analyze these data through the age , gender , major clinical manifestations , tumor size , pathological type , operative approach and prognosis of the patients'. On the second , screen these data again based on the standard which is composed by operation type and endocrine functional classification , make a packet classification of these data , and use SPSS software 16.0 to study if there is an independent influence to the incidence rate of hypothalamus dysfunction from the multiple factors like the age , gender , hydrocephalus , tumor size , surgical approach , excision extention and texture type , etc. Only when the p<0.05 will be counted .Result:1 The clinical records show that : (1) male third ventricle tumor patients are more than female , and the ratio is about 1:0.67 . (2) The young and juvenile people have a high risk of the tumor, the patients'age from 0 to 40 are 72.1% of all ,the patients'age from 20 to 40 are 43.9% of all .(3) The symptoms of intracranial hypertension , headache(69.7%) and vomit(34.42%)are the most common initial symptoms in third ventricle tumor patients ; visual disorder is at the second position : visual disorder( 23.77% ) and visual deficit ( 14.79% ) ; diabetes insipidus(12.29%) ; Endocrine symptom is at the fourth position : in female patients mainly manifested as amenorrhea( 9.02% ) ,and in males mainly manifested as sexual hypofunction(6.56%); Conscious disturbance(9.84%) .(4)101 patients have different level hydrocephalus ,which is 82.79% in all patients .(5) The transcallosal anterior approach(45.08%)and trans-cortex approach(39.34%)are the most superiority operation types . Other approach(triangular area and lamina terminalis) ( 15.58% ) (6) The tumors are basically craniopharyngioma(36.89%), glioma(27.87%)and Germ cell tumor (14.75%)on the pathological type . (7)The mortality rate is 14.75% , the most postoperative common complication in the near future is hypothalamus dysfunction which the incidence is 49.18% .2 The statistic analysis shows that : there is no obvious influence from the age , gender , hydrocephalus , texture type patient to the incidence of postoperative hypothalamus dysfunction . But the incidence of postoperative hypothalamus dysfunction by trans-cortex approaching surgery is higher than by transcallosal anterior approaching operation . Logistic regression analysis show that , the tumor size , operative approach , excision extention are the independent risk factors which the odds ratio(OR) are 2. 712,3.590(βis a positive number) and 3.238 , with 95% confidence interval 1.116～6.591,1.503～8.572 and 1.283～8.174 , respectively . All the p number is lower than 0.05 .Conclusion:1 In our town , the male third ventricle tumor patients are more than females . The patients'age from 0 to 40 have a high risk of the tumor . The tumors are basically craniopharyngioma , glioma and Germ cell tumor on the pathological type . Intracranial hypertension are the most common initial symptoms in the third ventricle tumor patients . The most common complication is hypothalamus dysfunction .2 The analysis improved that the tumor size , operative approach , excision extention are the independent risk factors to the incidence of postoperative hypothalamus dysfunction , while age , gender , texture type and hydrocephalus are not . |
