摘要
目的 :确定伽玛刀 (γ-刀 )治疗后脑水肿发生的相关因素。方法 :回顾一年内有完整随访资料的伽玛刀患者 47例。先探讨 γ刀治疗后脑水肿临床特征 ,然后采用 χ2检验从治疗病灶平均直径是否大于 2 .5 cm、是否有流空效应、治疗前有无病灶周围水肿、靶区内能否确切除外正常脑组织、边缘剂量是否大于 15 Gy诸变量中确定与脑水肿相关者。结果 :γ刀治疗后一年内脑水肿总的发生率为 17% ,多在治疗后半年内发生 ,对糖皮质激素反应良好、无症状性或一过性居者多 ,少数为顽固性或致死性。与脑水肿发生显著相关的因素为病灶平均直径大于 2 .5 cm、靶区内不能确切除外正常脑组织。结论 :放射性脑水肿是γ-刀治疗后的重要并发症之一。在剂量 -容积关系的指导下 ,选择合适病理类型和大小的病灶对于减少 γ刀术后脑水肿的发生具有重要意义。
Objective: To determine factors related to brain edema after γ knife radiosurgery. Methods: 47 patients with full one year followed data after γ knife radiosurgery were reviewed. Clinical characteristics of brain edema after γ knife radiosurgery were explored first. And then, the factors related to brain edema were determined from the following variates: average nidus diameter ≥ 2.5cm, existence of vascular void in nidus and perinidus edema before γ knife radiosurgery, unexclusion of normal brain tissue in target, margin dose ≥ 15 Gy, using χ 2 test. Results: The one year rate of brain edema after γ knife radiosurgery was 17%. The incidence time was mainly during half year. Most of them were asymptomatic or transient, with good effect to glucocorticoid treatment, minor of them were intractable or fatal. The factors related to brain edema after γ knife radiosurgery were average nidus diameter ≥ 2.5γcm and unexclusion of normal brain tissue in target. Conclusion: Brain edema is an important complication after γ knife radiosurgery. Based on dose volume effect model, to reduce the ocurrence of brain edema after γ knife radiosurgery, it is very important to select proper pathological type and size of nidus.
出处
《立体定向和功能性神经外科杂志》
2000年第2期73-76,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
