目的　总结 61例显微手术切除儿童髓母细胞瘤的经验 ,探讨儿童髓母细胞瘤手术治疗策略。方法　自 1 995～ 2 0 0 2年同济医院对 61例儿童髓母细胞瘤进行了显微手术治疗 ,其中男46例 ,女 1 5例 ,年龄 1～ 1 0岁 ,平均 6 .3岁。病程 3～ 2 5周 ,平均 6周。病变位于小脑半球 1例 ,60例肿瘤均位于小脑蚓部。肿瘤 1～ 3cm者 7例 ,3～ 5cm者 2 5例 ,大于 5cm以上者 2 7例。所有病例手术后通过影像学 (CT和MRI检查 )和生存质量的观察 ,随访 1～ 7年 (随访 5年以上 4例 ,2～ 4年 46例 ,2年以内 1 1例 )。半年、1年、3～ 5年分别复查CT或MRI ,6例患儿因经济原因仅在手术后半年时 ,复查 1次。结果　全组病例中 ,肿瘤全切 55例 ,大部切除 6例 ,手术死亡 3例 ,病死率为 4 .9% (3/61 ) ,未出现严重并发症。患儿生存质量得到提高。结论　掌握显微手术方法和手术中注意事项 ,有利于提高肿瘤切除程度及减少手术并发症 ,手术后必须辅助放疗 ,通过采取这些措施 ,将使儿童髓母细胞瘤获得良好预后 Objective To summarize the experience of 61 cases of microsurgery for excision of children’s medulloblastoma and to explore the surgical treatment strategy of children’s medulloblastoma. Methods From 1995 to 2002, 61 children with medulloblastoma underwent microsurgical treatment in Tongji Hospital. There were 46 males and 15 females with a mean age of 6.3 years (range, 1 to 10 years). Duration of 3 ~ 2 5 weeks, an average of 6 weeks. Lesions in the cerebellar hemisphere in 1 case, 60 cases of tumors were located in cerebellar vermis. Tumors in 1 ~ 3cm in 7 cases, 3 ~ 5cm in 25 cases, more than 5cm 27 cases. All cases were followed up for 1 to 7 years (4 cases were followed up for more than 5 years, 46 cases were 2 to 4 years, and 11 cases were less than 2 years) by imaging (CT and MRI) and quality of life after operation. Six months, one year, 3-5 years were reviewed CT or MRI, 6 cases of children due to economic reasons only in the six months after surgery, a review. Results In all the cases, there were 55 cases of complete resection, 6 cases of partial resection, 3 cases of surgical death, and the mortality rate was 4. 9% (3/61). There was no serious complication. Children’s quality of life is improved. Conclusion To grasp the microsurgical methods and precautions in operation is conducive to improving the degree of tumor resection and reducing the complications of surgery. Radiotherapy must be adjuvant after surgery. By adopting these measures, the prognosis of children with medulloblastoma will be good