妊娠合并颅内肿瘤的临床分析

发布时间：2018-03-12 13:37

本文选题：妊娠　切入点：颅内肿瘤　出处：《现代妇产科进展》2015年03期 　论文类型：期刊论文

【摘要】：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。
[Abstract]:Objective: to study the clinical characteristics of pregnancy complicated with intracranial tumor and its influence on mother and child. Objective: to investigate the pregnancy outcome of pregnant women with intracranial tumor. Methods: the clinical data of 16 cases of pregnancy complicated with intracranial tumor from October 1986 to September 2013 were retrospectively analyzed. Results: 16 cases of pregnancy complicated with intracranial tumor were treated in our hospital from October 1986 to September 2013. Four cases of maternal deaths, There were 12 cases of survival, 1 case of drug abortion, 1 case of spontaneous abortion, 6 cases of induced abortion and induced labor, 6 cases of neonatal survival. 2 cases of neonatal death. 14 cases of pregnancy complicated with intracranial tumor craniotomy. 1 case died because of lung and intracranial infection. 1 case of tumor recurrence, brain hernia, critical condition after operation of intracranial glioma. Postoperative pathological results: 6 cases of malignant tumor: 1 case of oligocytoma, 1 case of metastatic carcinoma, 1 case of astrocytoma, 1 case of anaplastic astrocytoma, 1 case of local gelatosis. There were 1 case of central nervous cell tumor, 1 case of mixed neuronal glioma, 8 cases of benign tumor, 3 cases of meningioma, 3 cases of neurilemmoma, 2 cases of neurofibroma. Early pregnancy with intracranial neoplasms should be terminated first and then diagnosed and treated with intracranial diseases. Caesarean section should be performed before craniotomy is performed immediately after 34 weeks of gestation. The progression of benign tumors is slow. Those who have a good response to corticosteroids may continue to be pregnant under monitoring; those with a high probability of malignancy and critical condition need to actively treat intracranial diseases; patients with previous history of surgery for intracranial malignant tumors should actively terminate pregnancy during the early pregnancy period. To prevent the recurrence and deterioration of tumor, cesarean section under general anesthesia is the best way of delivery, and at the same time, it is not suitable to take breast-feeding as well as to prepare for the rescue of newborns, and the mother and infant can get a better outcome.
【作者单位】：首都医科大学附属北京天坛医院妇产科;首都医科大学附属北京天坛医院麻醉科;
【分类号】：R714.25;R739.41

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