妊娠合并颅内肿瘤的临床分析  

The study of brain tumour during pregnancy

作　　者：于文[1] 黄春玉[1] 高婉丽[1] 梁辉[2] 侯晓慧[1] 梁竹巍[1] 李文君[1] 

机构地区：[1]首都医科大学附属北京天坛医院妇产科,北京100050 [2]首都医科大学附属北京天坛医院麻醉科,北京100050

出　　处：《现代妇产科进展》2015年第3期175-178,共4页Progress in Obstetrics and Gynecology

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。Objective：To study the clinical characteristics and the pregnancy outcomes of pregnancy complicated with brain turnout. Methods：A retrospective analysis of clinical data of 16 cases of pregnancy in patients with brain tumor from Oct. 1986 to Sep. 2013 in our hospital were ana- lyzed. Results：Among the 16 cases,tbere were 4 maternal deaths occurred and 12 cases of neonatal survived：l case of medical abortion, 1 case of spontaneous abortion,6 cases of artifical abortion and mid-term abortion,6 cases of neonatal survical, 2cases of neonata death. 14 cases of intraeranial tumors with surgical operation, l case die for lung and intracranial infection before craniotomy, an- other case whose intraeranial giioma tumor recurred after surgery ,who had cerebral hernia,and in a critical condition,the pregnant die after family give up surgical treatment. Postoperative pathological indicated that 6 patients with malignant tumor：l case of small sticks of glioma. 1 case of metastatic cancer. 1 case of astrocytoma glioma ;1 case of between the deformation of astrocytoma,local rubber mother variable. 1 case of neurocytoma. 1 case of mixed neuromal cell glioma. 8 cases with benign tumor ：3 cases of meningiomas ;3 cases of schwarlnoma ;2 cases of neurofibromatosis. Conclusions： Pregnancy complicated with brain tumour often occurs in the second and third trimester gestation. Early pregnancy combined intracranial tumor, we suggest to terminate pregnancy and then to treat intracranial diseases. The patient who 34 weeks of gestation,we do surgical operation after cesarean section. Any benign tumors progress slowly,response well to corticosteroids may continue pregnancy, Malignant tumor,which progress rapidly or in a critical condition,we should treat intracranial dis- ease actively. The patients who had history of intracranial malignant tumor surgery should be termi- nate gestation actively in early pregnancy. Cesarean section under general anesthesia is advisable. Neonatal rescue should be prepared. No breastfeeding. A be

关 键 词：妊娠 颅内肿瘤 妊娠结局 

分 类 号：R719[医药卫生—妇产科学]