论文部分内容阅读
目的:研究妊娠合并颅内肿瘤的临床特点及其对母婴的影响,探讨妊娠合并颅内肿瘤的孕妇的妊娠结局。方法:回顾分析1986年10月至2013年9月我院收治的16例妊娠合并颅内肿瘤患者的临床资料。结果:16例妊娠合并颅内肿瘤的孕产妇中死亡4例,存活12例;药物流产1例,自然流产1例,人工流产及中期引产6例,新生儿存活6例,新生儿死亡2例。妊娠合并颅内肿瘤开颅手术14例,1例未等开颅因肺部及颅内感染死亡,1例既往颅内胶质瘤术后肿瘤复发、脑疝、病情危重,家属放弃手术治疗后死亡。术后病理回报:恶性肿瘤6例:少枝胶质瘤1例,转移癌1例,星形细胞瘤胶质瘤1例,间变形星形细胞瘤,局部胶母变1例,中枢神经细胞瘤1例,混合神经元细胞胶质瘤1例;良性肿瘤8例:脑膜瘤3例,神经鞘瘤3例,神经纤维瘤2例。结论:妊娠合并颅内肿瘤多发生在中晚期妊娠;早期妊娠合并颅内肿瘤者,建议先终止妊娠再诊治颅内疾病;妊娠满34周者,可先剖宫产,再立即行开颅手术;良性肿瘤进展缓慢、对皮质激素反应良好者可在监控下继续妊娠;肿瘤恶性可能性大、病情危重者,则需积极治疗颅内疾病;既往颅内恶性肿瘤手术病史的患者应在早孕期积极终止妊娠,防止肿瘤复发、恶化。分娩方式以全麻下剖宫产为宜,并同时做好新生儿抢救的准备,不宜采取母乳喂养,母婴多可获得较好的结局。
Objective: To study the clinical features of intracranial tumors in pregnancy and their effects on maternal and infant, to explore the pregnant outcome of pregnant women with intracranial tumors in pregnancy. Methods: The clinical data of 16 patients with intracranial tumors of pregnancy who were treated in our hospital from October 1986 to September 2013 were retrospectively analyzed. Results: Of the 16 pregnant women with intracranial tumors who had pregnancy, 4 died and 12 survived. Among them, 1 was abortion, 1 spontaneous abortion, 6 abortion and mid-abortion, 6 neonates, 2 neonatal deaths . 14 cases of intracranial tumors during pregnancy were treated by craniotomy. One case died of pulmonary and intracranial infection without craniotomy. One case had recurrent tumors after intracranial glioma, death. Postoperative pathological findings: 6 cases of malignant tumor: 1 case of glomerulus, 1 case of metastatic carcinoma, 1 case of astrocytoma glioma, 1 case of anaplastic astrocytoma, 1 case of local colloid, 1 case of central nervous system 1 case of tumor, 1 case of mixed neuronal cell glioma; 8 cases of benign tumor: 3 cases of meningioma, 3 cases of schwannoma and 2 cases of neurofibroma. Conclusion: The intracranial tumors in pregnancy occur mostly in the late pregnancy; early pregnancy with intracranial tumors, it is recommended to terminate the pregnancy and then diagnose intracranial disease; 34 weeks of pregnancy who may be cesarean section, and then immediately craniotomy ; Benign tumors progress slowly, good response to corticosteroids can continue to monitor the pregnancy; the possibility of malignant tumors, those in critical condition, you need to actively treat intracranial disease; past history of intracranial malignant tumor surgery patients should be in early pregnancy Proactive termination of pregnancy to prevent tumor recurrence and deterioration. Mode of delivery under general anesthesia cesarean appropriate, and at the same time do a good job in neonatal rescue preparation, should not take breastfeeding, mother and child can get better outcome.