摘要
目的 探讨中枢神经系统副神经节瘤的诊断和治疗特点。 方法 1976～ 1999年手术治疗 17例副神经节瘤 ,其中颈静脉球瘤 11例 ,椎管内转移性副神经节瘤 2例 ,颈动脉体瘤、鞍区副神经节瘤、颞骨副神经节瘤及顶叶转移性副神经节瘤各 1例。术中采用系统动脉压降压 3例 ,亚低温麻醉 1例 ;术前行血管内栓塞治疗 7例 ;术后联合普通放疗 5例 ,联合γ 刀治疗 2例。 结果 肿瘤全切除 11例 ,次全切除 3例 ,大部切除 3例。术后 10d死亡 1例 ,远期随访 6个月～ 6年 ,1例格拉斯哥预后评分 (GOS) 3分 ,其余均 4～ 5分。 结论 临床表现结合影像学特点有助于临床诊断。手术全切除肿瘤为治疗首选方案 ,术后复发率低 ;术前栓塞应作为常规辅助治疗 ,可有效控制术中出血 ;术后放射治疗可控制残留肿瘤的生长。
Objective To explore the diagnosis and treatment of paragangliomas in the central nerve system. Methods 17 patients with paragangliomas in the central nerve system over a 20-year period (1976-1999) were analyzed retrospectively. They included 11 patients with glomus jugular tumors, 1 with carotid body tumor, 1 with supersellar paraganglioma, 2 with spinal involvement, and 2 with superficial hemisphere involvement. Results Neoplasm was completely resected in 11 patients, subtotally in 3, and partial in 3. The postoperative mortality was 1/17. One patient remained severe disability, yet the others had excellent long-time outcome. Conclusions Both the characteristic clinical presentation and neuroradiological manifestation were useful for preoperative diagnosis. Total resection is ideal for paragangliomas. Preoperative embolization should be used routinely to control intraoperative bleeding, and postoperative radiation-therapy would be valuable to control the recurrence of the remaining tumor.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2001年第12期931-934,共4页
Chinese Journal of Surgery
