脑实质内型表皮样囊肿临床特点及其治疗

Clinical features and treatment of intraparenchymal epidermoid cyst in the brain

目的探讨脑实质内型表皮样囊肿的临床特点及治疗方法。方法对27例脑实质内型表皮样囊肿的临床、影像表现及手术疗效进行回顾分析,并对术后无菌性脑膜炎的影响因素进行统计分析。结果肿瘤全切除20例,次全切7例。1例死亡,7例好转,3例复发。肿瘤直径、预防性腰椎穿刺、肿瘤全切、术腔冲洗,与无菌性脑膜炎相关(P<0.05),前二者经Logistic回归分析表明为最显著因素。结论全切肿瘤,地塞米松生理盐水冲洗术腔,术后做预防性腰椎穿刺引流,可以有效预防术后无菌性脑膜炎的发生。

Objective To explore clinical features and treatment of intraparenchymal epidermoid cyst in the brain.Methods Clinical manifestations,imaging findings and surgical treatment were retrospectively analyzed in 27 intraparenchymal epidermoid cysts in the brain.Factors affecting the occurrence of aseptic meningitis were analyzed by statistical methods.Results 20 cases of tumors were completely removed,and 7 cases were sub-totally removed.After surgery,1 patient died,7 were improved,and 3 had tumor recurrence.Statistical analysis showed that aseptic meningitis was related to the diameter of the tumor,use of prophylactic lumbar puncture,complete resection and irrigation of the tumor-bed by dexamethasone solution with normal saline,and the former two factors were most important by Logistic regression analysis.Conclusion Complete resection of tumors,use of prophylactic lumbar puncture and irrigation of the tumor-bed by dexamethasone solution with normal saline could reduce the occurrence of aseptic meningitis.