妊娠合并脑瘤12例临床分析

Clinical analysis of 12 patients with pregnancy accompanied by cerebroma

目的研究妊娠合并脑瘤的临床特点及对母婴的影响,探讨妊娠期特殊情况下脑瘤的诊断、产科处理及母婴预后。方法对1990-01至2013-02收入院的妊娠期脑瘤患者的临床资料进行回顾性分析。结果妊娠合并脑瘤患者听神经瘤1例,胶质瘤7例,脑膜瘤4例;其中手术11例,1例家属放弃手术自动出院;术后产褥期死亡6例,存活6例;足月新生儿5例,早产2例,早产儿死亡1例。结论妊娠期高雌孕激素水平可促使瘤体生长,孕前已确诊的胶质瘤患者不宜妊娠,妊娠晚期分娩方式以剖宫产为宜,中期妊娠可行引产术或小剖宫产术。早期可行人工流产术,妊娠期脑瘤发展快,定期产前检查,早期诊断并进行鉴别诊断是及时确诊、治疗,改善妊娠合并脑瘤患者预后的关键。

Objective To investigate the clinical characteristics of gravidas with cerebroma, diagnosis, preventive and thera- peutic methods, and the effects on maternal and infant health of cerehroma during this special period. Methods The clinical materials of several gravidas with cerebroma in this hospital from January 1990 to February 2013 were analyized retrospectively. Results There were 1 case of acoustic neurinoma, 7 cases of gliomas and 4 cases of meningoma. One patient gave up operation, while the other 11 de- cided to underwent operation of the knife with 6 cases of dying during the puerperium. 5 cases gave birth to full term infants and 2 cases premature infants with 6 cases of them staying alive and one of the premature infants dying. Conclusions The high estrogen level dur- ing pregnancy can accelerate the growth of cerebroma and eneephalic angioma. Patients with glioma are not suitable to be pregnant and artificial abortion can be chosen in early pregnancy. Induced labour and small cesarean section can be used during midterm. Caesarean section is the suitable delivery mode in the late trimester of pregnancy. The cerebroma during pregnancy grows quickly, so regular ante- natal examination, early diagnosis and just - in - time cure are the key to ameliorate the prognosis of gravidas with cerebroma.