CAJ | 학술논문

目的：探讨妊娠合并颅内肿瘤的临床处理。方法对本院1989~2012年收治的妊娠合并颅内肿瘤患者22例进行回顾性分析。结果22例患者中神经胶质瘤11例,脑膜瘤5例,血管网状细胞瘤2例,听神经瘤1例,成熟畸胎瘤1例,转移性肿瘤2例；经产妇11例,初产妇11例；早期妊娠4例,中期妊娠9例,晚期妊娠9例。22例患者中19例患者围产期接受开颅手术。早期妊娠4例患者中1例自然流产,3例人工流产；中期妊娠9例患者中1例因病情危重急行开颅手术无产科处理,中期引产6例,2例继续妊娠至晚期行剖宫产分娩；晚期妊娠9例患者中8例剖宫产分娩,1例自然分娩。11例新生儿早产儿5例,足月产儿6例；1例新生儿重度窒息生后5天死亡,其余10例新生儿均存活。结论妊娠本身并不增加罹患颅内肿瘤的风险,但妊娠可加速已存在的颅内肿瘤的生长,加重临床表现。妊娠合并颅内肿瘤患者的处理需产科和神经外科医生密切协作、共同管理,应充分评估孕母的肿瘤因素及孕周和胎儿成熟度以及妊娠意愿,权衡利弊,适时终止妊娠并进行神经外科手术治疗,在一定条件下仍可能取得良好的妊娠结局。
목적：탐토임신합병로내종류적림상처리。방법대본원1989~2012년수치적임신합병로내종류환자22례진행회고성분석。결과22례환자중신경효질류11례,뇌막류5례,혈관망상세포류2례,은신경류1례,성숙기태류1례,전이성종류2례；경산부11례,초산부11례；조기임신4례,중기임신9례,만기임신9례。22례환자중19례환자위산기접수개로수술。조기임신4례환자중1례자연유산,3례인공유산；중기임신9례환자중1례인병정위중급행개로수술무산과처리,중기인산6례,2례계속임신지만기행부궁산분면；만기임신9례환자중8례부궁산분면,1례자연분면。11례신생인조산인5례,족월산인6례；1례신생인중도질식생후5천사망,기여10례신생인균존활。결론임신본신병불증가리환로내종류적풍험,단임신가가속이존재적로내종류적생장,가중림상표현。임신합병로내종류환자적처리수산과화신경외과의생밀절협작、공동관리,응충분평고잉모적종류인소급잉주화태인성숙도이급임신의원,권형리폐,괄시종지임신병진행신경외과수술치료,재일정조건하잉가능취득량호적임신결국。
Objective To explore the management of intracranial tumors in pregnant women. Method We retrospec-tively analysised 22 pregnant women with intracranial tumors treated at Xuanwu hospital between 1989 and 2012.Result In 22 patients, there are 11 cases of glioma, 5 cases of meningioma, 2 cases of hemangioblastoma, 1 case of acoustic neuroma, 1 case of mature teratoma and 2 cases of metastatic tumor. Among them,11 cases of multipara, 11 cases of primipara. There are 4 cases of early pregnancy; 9 cases of mid pregnancy, 9 cases of late pregnancy. A total of 19 patients underwent neurosurgery operation. In 4 cases of early pregnancy, 1 case spontaneous abortion, 3 cases were performed abortion. In 9 cases of mid-term gestation, 1 case received emergency craniotomy operation immediately after admission without obstetric treatment because of critical condition,6 cases of mid-induced labor,2 cases continue the pregnancy to the third trimester and underwent cesarean section delivery. 8 cases of late pregnan-cy patients underwent cesarean delivery and the other 1 case of natural childbirth. In 11 neonatal,there are 5 prema-ture infants, 6 full-term infants. Among them,1 neonatal died five days later due to severe asphyxia, the rest 10 newborn were alive. Conclusion The incidence of intracranial tumors does not seem to be increased during pregnan-cy. However,pregnancy accelerates the growth of existing brain tumors,aggravates clinical manifestations. Manage-ment of intracranial tumors during pregnancy is challenging, obstetrician and neurosurgeons need close cooperation, joint management,we should fully evaluate tumor factors of motherhood and gestational age, fetal maturity and preg-nancy will, weigh the pros and cons, and timely termination of pregnancy and nerve surgical treatment. A good out-come of pregnancy might be get under proper management.