癌性脑脊髓膜炎

Carcinomatous meningitis

目的如何延长癌性脑脊髓膜炎患者的生存期。方法回顾13例癌性脑脊髓膜炎病人的诊治疗效。结果该病除脑积水、类似脑脊髓膜炎表现外往往无异常发现，因此容易误诊。脑脊液常规：压力、乳酸盐和蛋白增高，白细胞增多，糖、氯化物降低；细胞学：激活淋巴细胞增多，反复检查可发现肿瘤细胞。采取降颅压措施的同时给予放疗，其并发症明显低于鞘内化疗，且能延长患者的生存期。结论（1）该病误诊率高；（2）确诊依赖于脑脊液肿瘤细胞的发现；（3）全脑全脊髓放疗效果优于鞘内化疗。

Objective How to prolong the life span in patient of carcinomatous meningitis. Method To summarize 13 cases of patient treating courses. Results There are no findings expect for hydrencephalus and symptoms similar to meningitis in the early peroid of disease. So it is easy to be misdiagnosed. Typical changes in the cerebrospinal fluid include increased CSF, iactate, white cell, decreased glucose, chloridum and a high opening pressure. The activative lymphocyte and tumor cell can be found in CSF cytologycal examination. It has an advantage for patient to be given craniospinal radiotherapy than intrathecal injection, meanwhile dropping intracranial pressure. Conclusions （ 1 ） Carcinomatous meningitis is easy to be misdiagnosed. （2） Founding tumor cell in CSF can make a definite diagnosis. （3）It is better for patient to be given craniospinal radiotherapy than intrathecal injection.