X-刀治疗颅内病变的并发症及其防治  

Prevention and treatment of complications following X－ray stereotactic radiosurgery for intracranial lesions

作　　者：徐国政[1] 马廉亭[1] 潘力[1] 张新元[1] 姚国杰[1] 胡军民[1] 

机构地区：[1]广州军区武汉总医院神经外科,武汉430070

出　　处：《中国微侵袭神经外科杂志》2000年第3期148-150,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的 探讨 X－刀治疗颅内病变并发症的发病特点，研究并发症的预防和治疗。 方法 选择自1997年6月至1999年3月X－刀治疗的130例病人中发生并发症7例，分析并发症发病时间、类型以及与病变性质的关系等，研究治疗方法与结果。 结果 本组病例资料，并发症的发生率为5．38％，以水肿反应最为明显（70％）。并多见于晚期。而出血反应以早期和亚急性期为主（各1例）。并发症发生率最高为脑膜瘤，达28．6％（27），其次脑动静脉畸形（6．5％）和胶质瘤（4．2％）。脑转移瘤并发症的发生率最低（2．9％）。本组中死亡1例、重残1例。其余均经治疗后改善。 结论 X－刀治疗的并发症多见于脑水肿，与病变类型、大小、照射计量等有关，应提倡积极的预防和有效的治疗。Objective To evaluate the risks and characteristics of complications occurred after X－ray stereotactic radiosurgery （X－knife） and to study the proper way for its prevention and treatment． Method From June 1997 to march 1999, 130 cases with intracranial lesions were treated by X－knife, clinical data of these patients were analyzed retrospectively with emphasis put on the onset of post－operative complications, the type, and its relations with its original lesions． The therapeutic effects and outcome were also summarized briefly． Result The incidence of complications in the 130 cases was 5．38％（7130）, of which edematous reaction were most prominent （70％） and usually, seen in the late stage． Hemorrhagic reactions were found in 2 patients, one occurred early after operation and the other in the sub－acute stage． Higher incidence of complication was seen in patients with meningioma （28．6％）． One patient died and another patient survived with severe disability, the remaining 5 patients were improved significantly after treatment． Conclusion The complications after X－ray radiosurgery were closely related with the characteristics of the lesions including its types, the dose of irradiation, The size and the original location of the lesions． These results need to be replicated in prospective studies with large samples so as to improve the way for prevention and treatment．

关 键 词：X-刀 并发症 预防 治疗 颅内病变 

分 类 号：R651.1[医药卫生—外科学]