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中華神經外科雜志

中華神經外科雜志

北大核心

CSCD

CSTPCD

Chinese Journal of Neurosurgery
1985年創刊，中華醫學會主辦。本刊是我國神經外科專業領域的高級核心期刊，總編輯為我國著名的神經外科專家、中國工程院院士王忠誠教授。辦刊宗旨：貫徹執行黨和國家的衛生和出版工作方針政策，貫徹理論與實踐相結合、普及與提高相結合的方針，反映我國神經外科臨床科研工作重大進展，促進神經外科界的學術交流。該刊內容豐富，信息量大，涉及顯微神經外科、顱底神經外科、血管內介入神經外科、小兒神經外科、脊柱脊髓神經外科、立體定向與功能性神經外科、立體定向放射外科、神經放射、基礎研究等各個領域，有較高的學術權威性和學術導向性，內容重點報道神經外科領域的最新研究成果和最新動態，反映我國神經外科臨床與科學研究的重大進展以及新技術、新經驗和新方法，促進國內外學術交流。以廣大神經外科醫師、基礎研究人員及相關領域的專業人員為主要讀者對象。
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  • 發文量：7230
  • 被引量：3340
  • H指數：3
  • 開始收錄時間：1989,5(1)
  • CNKI綜合因子：1.011
  • 維普期刊影響因子： 1.220
  • 萬方期刊影響因子：1.4
  • 創刊時間：1985
  • 國內刊號/CN：11-2050/R
    國際刊號/ISSN：1001-2346
  • 發行周期：月刊
    郵發代號：18-56
  • 主管單位：中國科學技術協會
    主辦單位：中華醫學會
中華神經外科雜志-聯系信息
  • 主編：-
  • 電話：010-59975481
  • 郵箱：[email protected]
  • 地址：北京市豐臺區南四環兩路119號
  • 郵編：100070
中華神經外科雜志-獲獎情況
  • ? 1997年中國科協優秀科技期刊二等獎
  • ? 1995年中華醫學會成立80周年銀獎
  • ? 2002年獲“第三屆中國科協優秀科技期刊獎”
  • ? 2001～2003年均榮獲“百種中國杰出學術期刊”稱號
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中華神經外科雜志 >2021年第19期

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  • 摘要：目的 探討中樞神經系統惡性黑色素瘤的臨床表現、影像學特點及診治要點.方法 分析17例中樞神經系統惡性黑色素瘤的臨床表現、影像學特點、診治方法和療效.結果 17例中13例位于幕上,幕下小腦半球3例,頸髓1例.其臨床表現及體征無特異性,GT和MRI無法明確診斷.手術全切除12例,近全切除5例.病理檢查均證實為惡性黑色素瘤.隨訪14例,均死于術后腫瘤復發,最短于術后1個月死亡,最長于術后14個月死亡,術后中位生存期6.5個月.結論 中樞神經系統惡性黑色素瘤發病率低,誤診率高,預后差,以手術切除為主,可輔以化療、放療等綜合性治療.%Objective To investigate the diagnosis and treatment of CNS malignant melanoma.Methotis Seventeen patients with CNS malignant melanoma underwent surgery in our department between 1995-2008 were reviewed.Their clinical presentation,intraoperative findings,histological diagnosis,medical images and prognosis were studied.Results CNS malignant melanorna chould not be definitely diagnosed according to symptoms,signs and medical images.Thirteen lesions located in cerebral hemisphere,three in cerebellar hemisphere and one cervical cord.Total resection was achieved in 12 cases,and subtotal resection in 5 cases.Histological examination showed malignant melanoma in all 17 cases.Fourteen cases were followed up and all died due to tumor recurrence from one to fourteen months and the median survival time was 6.5 months.Couclusionn Malignant melarlonla is extrendy rare.Misdiagnosis rate is high and prognosis is poor.Combined therapy including chemotherapy and radiotherapy should be considered on the basis of operation.
  • 摘要：我國神經外科醫生對脊髓脊柱病變的外科治療主要是脊髓腫瘤，而發病率較高的椎間盤病變、脊髓脊柱損傷等常見病幾乎多由骨科醫生治療，而在國外對脊柱病變的外科治療主要是神經外科醫生處理。如此差異是否需要改變？神經外科如何與國際接軌？這些問題是我們廣大神經外科醫生所共同關心的問題。
  • 摘要：Objective To introduce a rare post-operative complication,delayed intracranial hemorrhage in epidermoid cyst cases,to summarize its clinical features and improve the prognosis.Methods A1l epidermoid cyst cases treated in our department from Jam 1985 to Dec.2008 were retrospectively reviewed.The clinical features and high risk factors were analyzed in the cases suffered from delayred intracranial hemorrhage.Results In all 737 epidermoid cyst cases.719 cases underwent operation,delayed intracranial hemorrhage occurred in 15 cases(2.0%),5 Male and 10 female cases,the mean age was 39±8 yrs,the hemorrhage occurred during 9±3.7 days postoperatively,10 of the 15 cases dead.Conclusion In intracranial epidermoid cyst cases.the postoperative period between 5th to 18th days is the high risk time-window for delayed intracranial hemorrhage,there was no statistically significant risk factor available at present,so neurosurgeon should be cautious with this rare complication.%目的 介紹顱內表皮樣囊腫手術后一種罕見并發癥--自發性顱內出血,總結分析其臨床特點,提高對該并發癥的認識,改善患者預后.方法 回顧1985年1月至2008年12月診治的所有表皮樣囊腫患者的臨床資料,分析該并發癥的病例特點及高危因素.結果 顱內表皮樣囊腫患者共737例,其中手術治療719例,術后出現自發性顱內出血15例(2.1%),男5例,女10例,(男/女=1:2),平均年齡(39±8)歲,出血發生在術后第(9±3.7)天,死亡10例(66.7%).結論 顱內表皮樣囊腫術后第5-18天為發生致命性顱內出血的高危期,目前尚無規律町循,因此應提高對這種罕見并發癥的警惕,爭取早發現,早搶救,改善患者預后.
  • 摘要：Objective To explore the significance of modified far-lateral approach in the resection of C1～C2 dumbbell-shaped neurilemmomas.Method A retrospective analysis of the clinical data and prognosis of mierosurgery was performed in 10 C1～C2 dumbbell-shaped neufilemmoma cases.Results Of the 10 cases.total resection Was achieved in 8 cases and subtotal resection in 2 cases.6 cases recovered from root pain soon after the operation.All these patients were followed up from 3 months to 5 years,among which 2 cases recovered and 1 case partially recovered from hemiplegia.3 cases got partial recovery from local numbness.1 patient suffered from tumor recurrence at the 4th year after operation underwent the second microsurgery.Conclusion Modified far-lateral approach could be preferred in the resection of C1～C2 dumbbell-shaped neurilemmomas.%目的 探討改良遠外側入路在切除C1～C2啞鈴形神經鞘瘤中的意義.方法 對10例經改良遠外側入路切除的C1～C2啞鈴形神經鞘瘤的臨床資料和手術效果進行分析總結.結果 腫瘤全切者8例,次全切者2例,術前有神經根痛的6例患者術后均緩解,無新的神經系統并發癥產生,無手術死亡.隨訪3個月-5年,術前有肢體肌力障礙的3例中,2例已恢復正常,1例有明顯改善,3例術前有麻木癥狀者亦有所好轉,腫瘤全切的8例中有1例于術后第4年復發,行二次手術全切腫瘤.結論 改良遠外側入路在切除C1～C2啞鈴形神經鞘瘤手術中具有重要意義.
  • 摘要：無
  • 摘要：患者 女，17歲.因陣發性頭痛4個月，右側腦室-腹腔分流術后30d于2007年9月19日入院。查體：神清，語利，視力正常，陣發性呼吸困難，頸項稍僵硬，四肢肌力、肌張力正常，右側輪替試驗（＋）、指鼻試驗（＋）、Romberg征（＋）。無家族病史。CT及MRI可見右側小腦半球一大小約4．5cm×4．0cm×3．6cm囊性占位性病變，延髓背側一大小約3．8cm×3．8cm×3．5cm實質性占位性病變，
  • 摘要：對于局限型垂體腺瘤（直徑〈2cm，鞍內）采取傳統的經鼻蝶竇入路可全切腫瘤。而對于侵襲性垂體腺瘤（直徑〉2cm，侵入鞍旁海綿竇），如何行擴大入路盡可能切除腫瘤引起廣泛的討論。
  • 摘要：彌漫性軸索損傷（diffuse axonal injury，DAI）是以腦白質廣泛性軸索腫脹、斷裂、軸縮球形成為主要病理特征的特殊類型腦損傷。由于患者多昏迷，缺乏特異性體征，故早期診斷較為困難。目前DAI的診斷主要依賴影像學，特別是MRI檢查。但昏迷患者早期往往因躁動而無法配合檢查，此外，需較長時間離開監護設備、費用較高等因素也限制了其在早期診斷中的應用。近年來，生物標記物在早期診斷、病情監測、預后評估方面的作用得到了國內外學者的重視，本文對該領域的研究進展加以綜述。
  • 摘要：Objective To study the inhibition of U251 human glioma cell line proliferation by knocking down of miR-21 expression in vitro and the possible mechanism.Methods Oligofectamine was used to transfect miRNA-21 antisense oligonucleotides to knock down the miR-21 expression level of U251 human dioma ceill line in vitro.In-situ hybridization and real-time PCR were conducted to detect the miRNA expression of miR-21 anlong different treated groups.The proliferation ability of AS-miR21.scramble and control treated U251 glioma cell were determined by MTr assay.The biological characteristics of U251 cells were evaluated by immunofluoresenee staining and cell flow cytometry.Results The expression level of miR-21 was significantly knocked down bv AS-miR-21 treatment.As MTT assay showed,the tumor cell survival rate was inhihired significantly(F=78.926,P=0.000).G0/G1 phase cell cycle arrest was founded(X2=14.160,P=0.007)and tumor cell apoptosis was induced in As-miR-21 group(F=23341.25,P=0.000).The expression of PCNA.CyelinDi and Bcl-2were down-regulated and mN and Septin-7 were up-regulated iu the AS-miR-21 treated tumor cells.Conclusions The suppressive effect of anti-miR-21 ODNs on the growth of U251 human glioma cell line is significant and miR-21 can be taken as a candidate for gene therapy of human glioma.%目的 探討敲低miR-21表達抑制U251人腦膠質瘤細胞株增殖能力的效果和機制.方法 脂質體介導轉染反義寡聚核苷酸(AS-miR-21)下調U251人腦膠質瘤細胞株miR-21的表達.使用實時定量PCR和原位雜交法鑒定轉染后U251細胞miB-21表達水平下調;MTY法評價AS-miR-21抑制U251細胞生長效果;流式細胞術檢測轉染后U251細胞周期分布和凋亡;采用細胞免疫熒光技術(PCNA、CyelinD1、Bcl-2、PTEN和Septin-7)評價轉染后U251細胞腫瘤生物學性狀改變.結果 MTT結果顯示AS-miR-21轉染組腫瘤細胞生長速度小于對照組與無義寡核苷酸(F=78.926,P=0.000)組;實時定量PCR法:AS-miR-21轉染組miR-21表達下調為對照組0.042±0.012;LNA-miR-21原位雜交顯示AS-miR-21轉染組miR-21表達水平較對照組與無義寡核苷酸組下調;流式細胞術檢測可見AS-miR-21轉染組細胞周期存在G0/G1期阻滯(X2=14.160,P=0.007)且凋亡比例高于對照組與無義寡核苷酸組(F=23341.25,P=0.000);細胞免疫熒光法表明AS-miR-21治療后U251細胞PCNA、CyclinD1、Bcl-2表達下調,PrEN、Septin-7表達上調.結論 以miR-21作為靶點抑制U251人腦膠質瘤細胞株生長結果肯定,miR-21可以作為人腦膠質瘤基因治療的侯選靶點.
  • 摘要：目的 探討上頜動脈(MA)與頸內動脈(ICA)搭橋的可行性.方法 5具成人尸頭行雙側解剖,解剖顳淺動脈(STA)、MA、頸外動脈(ECA)、ICA并測量其血管外徑;額顳瓣開顱,顯露ICA床突上段并測量其外徑;在蝶骨上磨一骨孔,測量MA與ICA之間距離以及ECA和ICA起始段到ICA床突上段之間距離,比較所測得數據和移植物行走路徑.結果 MA血管外徑(2.66±0.20)mm大于STA分叉部的血管外徑(1.92±0.15)mm.MA與ICA之間的距離(4.69±0.34)cm小于ECA、ICA起始段與ICA床突上段之間的距離(17.76±0.47)cm和(18.11±0.51)cm.結論 MA與ICA之間搭橋在解剖上是可行的,具有移植血管短、路徑直的優點.%Objective To examine the feasibility of bypass between the second segment of maxillary artery(MA)and supraclinoid intemal carotid artery(ICA).Methods Five fixed and perfused adult cadaver heads were carried out bilaterally.After a frontotemperal craniotomy,the superficial temperal artery (STA)and jts branches were.dissected and their diameters at the bifurcation of STA were measured.The MA was located in the infratemporal fossa,following a zygomatic arch osteotomy.and its diameters were measured.After the sylvian fissure was opened.the supraclinoid ICA was separated and its outer diameter Was measured.Extradurally 1～2 cm lateral to the foramen rotundum.a hole Was created in the sphenoid bone with a4.0 mm tip drill.The length between MA and ICA was measured.After ECA and ICA had been exposed,their diameters lengths between the proximal ECA,proximal ICA and supraclinoid ICA were measured respectively.Remlts The mean caliber of MA(2.66±0.20)mm,was larger than the mean caliber ofsTA trunk(1.92±0.15)mm.The length between MA and supraclinoid ICA Was(4.69±0.34)cm,which WaS shorter and straishter than the route between proximal ECA or ICA tO supraclinoid ICA (17.76±0.47)cm and(18.11±0.51)cm separately.Conclusions The MA-to-ICA bypass may be an alternativc to STA to MCA bypass as well as to ECA or ICA to supraelinoid ICA bypasses.
  • 摘要：例1男，44歲。因頭部外傷半小時入院，傷時有短暫昏迷史。就診時神志清，頭顱CT示左顳微量硬膜外血腫，蛛網膜下腔出血，左顳骨骨折。約4h后病人昏迷，左側瞳孔4．5mm，右側瞳孔2．0mm。頭顱CT示左顳頂及后顱窩巨大硬膜外血腫，量約120ml。急診行后顱窩及左顥頂開顱血腫清除術，見左側橫寞及上矢狀寞中部均有出血，清除血腫，橫竇處保留骨橋，
  • 摘要：@@ 隨著現代影像技術和顯微神經外科技術的提高以及各種脊柱固定技術的應用,如果治療及時,椎管內腫瘤所致的完全癱瘓和功能喪失將大大降低,甚至是能夠避免的.但我們在臨床實踐中發現,手術處理中還存在一些需要注意和解決的問題,現提出供大家參考和討論.
  • 摘要：@@ 以往髓內腫瘤切除術多采用椎板切除術,脊髓敞開減壓,縫或不縫合硬脊膜.這樣術后易造成脊髓與肌肉組織的粘連,脊髓后移,形成橫向拴系,產生新的癥狀.同時由于椎板的切除,往往會造成脊柱后突畸形.尤其在頸段,更易形成鶴頸畸形.根據我科1200余例椎管內手術的經驗體會,采用"解剖學復位技術"可避免這兩種情況的發生.
  • 摘要：Objective To study the diagnostic and therapeutic significance of edema-like change along the optic tract. Method The pathology is hypothalamic-optic pathway glioma (HOG) in 19 cases, suprasellar germ cell tumor (GCT) in 13 cases, chordoma (CHO) in 9 cases. All patients were newly diagnosed and the tumors compressed the optic chiasma and/or optic tract. The MRI radiological features were retrospectively analyzed. Results The positive ratio of edema-like change in HOG, GCT, CHO was 36.8%, 46.2% and 0%, respectively. The edema-like change was independent of tumor size as well as presence or absence of visual signs. The edema-like change in nearly 2/3 of the patients disappeared or reduced in early postoperative MRI follow up. Conclusions Edema-like change is not characteristic radiological feature of craniopharyngioma. After successful tumor removal, the edema-like change may disappear or reduce. If not, other reasons should be considered such as tumoral infiltration along the optic tract, especially in HOG.%目的 研究MRI視束水腫樣變的診斷和治療學意義.方法 下丘腦視路膠質瘤19例、鞍上生殖細胞腫瘤13例、脊索瘤9例,均為初診且腫瘤壓迫視交叉和(或)視束,回顧性分析MRI上視束水腫樣變的特點.結果 視束水腫樣變在下丘腦視路膠質瘤、鞍上生殖細胞腫瘤、脊索瘤的陽性率分別為36.8%、46.2%和0%,腫瘤大小及術前視覺功能障礙在視束水腫樣變陽性和陰性患者間差異無統計學意義,視束水腫樣變近2/3在術后早期即可消失或減輕.結論 視束水腫樣變不是顱咽管瘤的特征性表現,在手術滿意切除腫瘤后,視束水腫樣變多可消失或減輕,否則需考慮腫瘤視束內浸潤或其他原因,特別是下丘腦視路膠質瘤.
  • 摘要：@@ 在原發性三叉神經痛微血管減壓術中,有人認為巖靜脈或其屬支是壓迫三叉神經根引起三叉神經痛的重要責任血管,為了解其存在的解剖學基礎,我們對巖靜脈和三叉神經的關系進行研究,向臨床提供解剖學資料.rn一、資料與方法rn選經10%甲醛固定的成人頭頸標本3例,進行紅、藍硅膠灌注,自中腦水平切除大腦半球等結構,保留小腦幕.
  • 摘要：@@ 我科自2005年1月至2008年1月急診手術治療疑為動脈瘤破裂致腦內血腫36例病人,體會如下.rn一、資料與方法rn1.一般資料:本組36例,男20例,女16例;年齡45～72歲,平均62.5歲;發病時間1-23 h.臨床以突發劇烈頭痛、惡心嘔吐,隨著意識喪失、病情危重為主要表現.腦出血后意識狀況分級:Ⅲ級15例,Ⅳ級21例.
  • 摘要：@@ 一、資料與方法rn1.一般資料:2002年3月至2008年1月,我科采用不同手術方式治療慢性硬膜下血腫共155例,男147例,女8例;年齡41～76歲,平均63.2歲;均行頭顱CT檢查確診,CT掃描血腫為低密度、等密度、高密度或混雜密度,患者表現為顱高壓癥狀、精神癥狀、偏癱、意識障礙等.
  • 摘要：目的 探討磁共振彌散張量成像(DTI)在運動區腦星形膠質細胞瘤惡性程度預測及手術方案制定的臨床應用價值.方法 33例運動功能區星形細胞瘤患者,術前進行DTI檢查,測量表觀彌散系數(ADC值)及各向異性分數(FA值)并重建i維白質纖維束示蹤圖(DTT圖).結果 不同級別星形細胞瘤的腫瘤實質區ADC值及瘤周水腫區FA值存在差異;DTT圖可以清楚顯示運動區錐體束形態變化及與腫瘤之間的關系,在此基礎上指導手術,效果滿意.結論 DTI中ADC、FA值可以區別腫瘤組織與正常神經組織,有助于星形細胞瘤分級;DTT圖可以優化運動功能區星形細胞瘤切除的手術方案,可最大范圍切除腫瘤并有效保護重要白質纖維束.%Objective Astrocytic tumors in motor area often grow infihratively with worse outcome. It is significant to identify the tumor infiltrating field before the operation to improve the outcome of surgery. Diffusion tensor imaging(DTI) is an advanced quantitative form of diffusion-weighted imaging. The study is to discuss the clinical application of DTI in identifying, forecasting the grades of astrocytoma and choosing the best procedure for resecting astrocytoma. Method The clinical data of consecutive 33 patients with astrocytoma in motor function area underwent DTI examination before the operation. Results Compared with normal brain tissue, significant differences of ADC and FA were found in solid area of astrocytoma necrotic region, edema region(P<0.05). Significant differences of ADC were also found in solid tumor compared with necrotic region and edema region respectively(P<0.05). By the imaging guidance of DTI, we could show white matter fiber tracts of the motor area and evaluate the relationship between astrocytoma and white matter fiber for the operation. Conclusions ADC and FA can be used to differentiate normal brain tissue from astrocytoma. According to the change of white matter fiber tracts around the tumors in DTT, we could optimize the operational project and improve the resection of astrocytoma significantly, as well as to decrease potential disability after operation.
  • 摘要：@@ 顱內動脈瘤是顱內動脈壁上的異常膨出,體積較小的在破裂之前多無癥狀,臨床表現多以蛛網膜下腔出血(SAH)為主要表現,可合并腦血管痙攣,發病2周內再出血患者死亡率極高,宜盡早進行有效治療.栓塞治療顱內動脈瘤創傷小、安全、效果好.現在此技術已得到迅速發展.我們應用此技術治療顱內動脈瘤36例,療效滿意,現將護理體會總結如下.
  • 摘要：@@ 神經外科手術后的病人由于麻醉、創傷、顱壓高、保留氣管插管、外界刺激等因素的影響,在麻醉恢復的過程中,表現出不同程度的躁動,不利于護理.我院中心ICU于2008年10月1日至12月31日應用咪噠唑侖治療手術后出現躁動的病人87例,治療和護理效果顯著,現做如下報告.
  • 摘要：Objective To discuss effect and clinical classification of 102 patients with cerebral hydatid cysts retrospectively. Method According to hallmark of clinical manifestation and imaging,hydatid cysts were divided into two types,one is echinococcosis granulosa,the other is echinococcsis multilocularies. Echinococcosis granulosa were totally resected by dowling method and echinococcsis muhilocularies were also totally ablated. Results Of 102 patients,94 patients were totally removed without cysts rupture,8 cases were totally with cysts rupture, and 3 cases were died of allergic shock with infection. Five cases relapsed and reoperated. Conclusions Despite any kinds, patients can be cured when the hydatid cysts were totally removed. But suegeons should avoid allergic shock by en block resection without cysts rupture.%目的 探討顱內包囊蟲手術治療的療效和臨床分型.方法 回顧分析102例顱內包囊蟲患者,男56例,女46例,中位16.8歲.細粒棘球蚴采用注水漂浮法完整摘除,泡狀棘球蚴行腫塊完整切除術.結果 細粒棘球蚴患者中94例完整摘除,包括8例破潰后摘除,其中3例因過敏性休克死亡,5例采用阿苯噠唑脂質體治療有效.泡狀棘球蚴8例經手術全切,僅有1例長期生存,其余7例因并發肝臟泡狀棘球蚴反復復發而死亡.結論 細粒棘球蚴和泡狀棘球蚴只有完整摘除和切除,患者才可得治愈.手術中一定要操作仔細輕柔以免破潰導致過敏性休克并發感染死亡或包囊蟲復發.
  • 摘要：Objective To explore the risk factors of ventricle inflammation in enfants and its treatment. Method Clinical data about 80 infants suffering ventricle tumors and post operative waterhead were collected for the analysis of the risk factors of ventricle inflammation and its effective therapeutic methods. Results 9 cases were diagnosed as ventricle inflammation, accounting for 11.25% of the total cases. Continuous intraventricle drainage of vancomycin and systemic application of efficacious antibiotics were undertaken in all of these 9 cases, all of whom were cured, proving effective. Conclusions Extraventricle drainage represents the main reason for ventricle inflammation, and strict asepsis during operation and postoperative medication renewal of incision, restricting drainage time can reduce the onset of ventricle inflammation. Continuous intraventricle drainage of vancomycin represents one of the effective therapeutic methods for the treatment ventricle inflammation.%目的 探討兒童腦室感染的易患因素與治療措施.方法 回顧性分析80例兒童腦室系統腫瘤、腦積水術后的臨床資料,分析腦室感染的易患因素及有效的治療方法.結果 80例患者中發生腦室感染9例,發生率為11.25%,均采用腦室內萬古霉素灌洗持續引流治療及全身合理使用有效抗生素,收到良好效果,9例全部治愈.結論 腦室外引流是腦室感染的主要原因之一,嚴格的術中無菌操作及術后腦室外引流時限的控制,以及換藥處置時嚴格的無菌操作,可減少腦室感染的發生,萬古霉素腦室內灌洗持續引流是治療腦室感染的有效措施.
  • 摘要：@@ 一、資料與方法rn1.一般資料:2004年5月至2007年8月共收治膠質瘤主體位于皮質運動區的患者22例,男10例,女12例;年齡6～70歲,平均42.6歲.頭痛頭暈15例,肢體偏癱或單癱19例,癲癇發作8例,感覺障礙7例,吐字欠清3例,精神癥狀4例,視力下降2例.
  • 摘要：@@ 腦室外引流術是神經外科的常見手術,簡單而且有效,能迅速緩解顱內高壓癥狀,挽救病人的生命.現總結我院2005-2007年間因蛛網膜下腔出血(SAH)破入腦室行腦室外引流的67例患者手術前后的護理經驗.rn資料與方法rn男38例,女29例;年齡28～81歲,平均年齡56歲.
  • 摘要：@@ 隨著影像技術和顯微手術技術的發展,顯微手術切除已經成為治療髓內腫瘤的首選和最主要的治療手段.我科于2000年2月至2007年8月共收治髓內膠質瘤病人31例,現將治療情況和結果報告如下.rn資料與方法rn1.一般資料:男18例,女13例.年齡5～49歲,平均29.5歲.
  • 摘要：目的 提高對顱內軟骨瘤臨床特點及診治方法的認識.方法 回顧性分析經病理學證實的30例顱內軟骨瘤病人的臨床資料、影像學特點及治療方法.全部病人行手術治療,5例病人術后行放射治療.結果 顱內軟骨瘤主要發生在顱底軟骨的結合處,多見于中顱窩,臨床表現為頭痛及多組腦神經損害癥狀.影像表現多數伴有明顯鈣化,相鄰骨質可受累.手術33例次,有3例病人復發后再次行手術治療.腫瘤全切除11例次,近全切除13例次,大部及部分切除9例次.手術死亡1例.隨訪到26例病人,平均時間為45.8個月.恢復正?；顒?1例,復發3例,死亡2例.結論 顱內軟骨瘤手術不易全切除,放療效果不確定.臨床和影像方面不易與黏液瘤及脊索瘤鑒別,病理仍是主要確診手段.%Objective To study the clinical manifestations and diagnosis and treatment of intracranial chondroma. Method The clinical data of 30 cases of intracranial chondroma confirmed by pathology from Sep. 1996 to Jun. 2008, 12 males and 18 females, aged 35.4 (16～60), were analyzed retrospectively. Operations were performed on all 30 patients,5 cases underwent radiotherapy postoperatively. Results The tumor usually arise from the embryonic cartilaginous remnants of chondrogenic cells at the basilar synchondroses of the cranial base with a predilection for the parasellar region and middle fossa. The clinical manifestations included headache and injury of multiple cranialnerves. Imaging examination usually showed well-demarcated masses with calcifications in 60%～90% of the cases. The approaches of operation were selected according to the tumor position. Total resection was achieved in 11 cases, subtotal resection was achieved in 13 cases,and gross resection in 9 cases. 26 patients were followed up after operation for mean time 45.8 months. The follow up showed that recuperation was achieved in 21 cases, recurrence occurred in 3 cases,and 2 patients died. Conclusions It is difficult to remove the tumor totally. The curative efficacy of radiotherapy is not definite. It is difficult to differentiate chondroma from myxoma and chordoma by the clinical and neuroradiological manifestations. Pathology is still the main diagnosis means.
  • 摘要：@@ 顱內神經鞘瘤約占顱內原發腫瘤的8%,通常起源于腦神經主干許旺細胞(SCs),非源于腦神經主干者罕見,僅占此類腫瘤的1%[1].腦實質內神經鞘瘤最早報道于1965年[2],發病性別無差異,年齡6個月～84歲[2-3],70%的患者在30歲前出現癥狀,大多表現為頭痛、癲癇發作及局灶性神經定位損害體征[4].
  • 摘要：Objective To explore the therapeutic efficacy of microsurgery in cystic cerebral parenchyma type cysticercosis. Method A retrospective analysis of the clinical data and prognosis of microsurgery was performed in 11 cystic cerebral parenchyma type cysticercosis cases. Results All head-segments found in the cysts were removed completely. Total resection was achieved in 9 cases and subtotal resection was achieved in 2 patients. The lesions were proved to be cerebral cysticercosis according to pathologic results. All these patients were followed up for about 3 months to 6 years, among which 5 cases recovered from the hypercranial pressure soon after the operation,6 cases with epilepsy before were epilepsy free after the operation, 2 cases recovered from the bemiparesis within 6 months after operation, 1 patient almost recovered from the cerebellar ataxia. 1 patient lost follow up. Conclusions The misdiagnosis rate of cystic cerebral parenchyma type cysticercosis was high, but satisfactory clinical outcome of microsurgery can be accomplished.%目的 探討腦實質型囊性囊蟲病的診斷與顯微手術治療效果.方法 對11例行顯微手術治療的腦實質型囊性囊蟲病患者的手術效果進行分析總結.結果 病灶內有頭節的患者頭節均被摘除,9例患者囊壁全部摘除,2例患者囊壁大部分摘除,術后病理均證實為腦囊蟲.隨訪3個月-6年,有癲癇的6例患者術后癲癇均控制良好,術前有顱高壓的5例患者術后癥狀立即明顯改善,術前有肌力障礙的2例患者術后6個月內肌力均恢復正常,有共濟失調癥的1例患者該癥狀亦明顯減輕.失訪1例.結論 腦實質型囊性囊蟲病誤診率較高,但顯微手術治療效果良好.
  • 摘要：Objective To analyze the features and risk factors of secondary intracranial hematomas after microsurgery of intracranial tumors. Method The clinical records of the patients with secondary intracranial hematomas after brain tumor surgery were analyzed retrospectively. Results 19 out of 702 patients with brain tumor resection were suffered from secondary intracranial hematomas, all of which were found in 48 hours,and 16 were found in 24 hours. 12 cases with signs of heniation and others were found by regular CT scan. The patients had average blood loss of 1102.63 ml and external ventricular drainage were performed during surgery in 5 cases. Hematomas were eliminated in all of the 19 cases, and the outcomes of 12 patients were good, but there were also 4 cases with functional impairments, one in persistent vegetative state, and two death. Conclusions It is important for thoroughly evaluations of the risk factors to decrease the secondary intracranial hematomas, and the key points of the management for patients with secondary intracranial hematomas should be early detection and treatment.%目的 總結顱內腫瘤術后繼發血腫的病例,探討防治對策.方法 回顧性分析手術切除顱內腫瘤后繼發血腫的臨床資料.結果 702例顱內腫瘤病人術后19例(2.71%)繼發顱內血腫;均發生于術后48 h內,16例發生于24 h內;12例病例出現腦疝或腦疝前期癥狀,7例為術后CT檢查發現;繼發血腫病例術中失血量平均為1102.63 ml;5例曾行腦室外引流;再次手術血腫清除后痊愈12例,部分神經功能障礙4例,植物生存1例,死亡2例.結論 術前、術中對患者危險因素的充分評估以及術后的密切監測是減少繼發血腫的前提,治療的關鍵在于早期發現、早期行血腫清除.
  • 摘要：@@ 應用雙側額顳頂去大骨瓣減壓術同時硬腦膜敞開或減張縫合治療雙側急性顱內血腫或彌漫性腦腫脹,可以有效地清除血腫,解除腦疝、顱高壓,降低病死率和傷殘率,常被用來救治重型及特重型顱腦創傷[1].但大骨瓣減壓術后并發同側或對側骨窗下積液時有發生[2].

    中華神經外科雜志的期刊信息

    • 創刊時間：1985
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    • 語言：中文
    • 熱門主題：中華醫學會
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    中華神經外科雜志的獲獎情況

    • ? 1997年中國科協優秀科技期刊二等獎
    • ? 1995年中華醫學會成立80周年銀獎
    • ? 2002年獲“第三屆中國科協優秀科技期刊獎”
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    中華神經外科雜志的收錄情況

    • ? 北大核心期刊（1992版）
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    • ? 中國科學引文數據庫（2011-2012）
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