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解放军总医院第一附属医院为一少女切除巨大脑膜瘤

2014-03-06 驻地记者张献怀 中国医学论坛报

日前,解放军总医院第一附属医院神经外科为1例15岁少女成功切除11cm×8.5cm巨大脑膜瘤。术后患者神智清楚,语言流利,肢体功能恢复正常,于2月17日康复出院。该院神经外科主任张志文教授说,如此巨大的脑肿瘤临床上实属罕见。 春节前的一天晚上,患者在无任何征兆的情况下,突然意识不清,摔倒在地,四肢抽搐持续约半个小时。到当地医院进行头部核磁检查,发现颅内有一巨大不规则团块状占位,局部中线结

日前,解放军总医院第一附属医院神经外科为1例15岁少女成功切除11cm×8.5cm巨大脑膜瘤。术后患者神智清楚,语言流利,肢体功能恢复正常,于2月17日康复出院。该院神经外科主任张志文教授说,如此巨大的脑肿瘤临床上实属罕见。

春节前的一天晚上,患者在无任何征兆的情况下,突然意识不清,摔倒在地,四肢抽搐持续约半个小时。到当地医院进行头部核磁检查,发现颅内有一巨大不规则团块状占位,局部中线结构挤压右移。于是慕名到解放军总医院第一附属医院神经外科求治。

张志文和主任医师闫润民等检查发现,患者前颅底有一直径11cm×8.5cm的巨大占位,挤占了整个颅腔的四分之一还多。肿瘤向下侵犯筛窦,将大脑前动脉、胼胝体、下丘脑漏斗和垂体柄向后、向右推挤,瘤内有多处钙化灶,初步诊断为前颅窝巨大脑膜瘤伴发症状性癫痫。

张志文组织全科进行了多次病例讨论后,制定了手术方案及术中、术后的应急预案。随后,手术团队为患者施行了颅内肿瘤全切、颅底修复重建术,切除肿瘤重约200g,出血约100ml,未伤及血管及周围结构组织。

术后患者出现下丘脑部位复位移动,一度血钠较低,临床上称为“脑性耗盐综合征”。由于术前已有充分评估并制定了应急预案,经过医护人员的精心调理,患者顺利恢复,血钠逐步正常,无颅内出血和颅内感染等并发症。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1923437, encodeId=9184192343e7d, content=<a href='/topic/show?id=ef2f52e50d4' target=_blank style='color:#2F92EE;'>#总医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52750, encryptionId=ef2f52e50d4, topicName=总医院)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf1d2500084, createdName=1249884fm87暂无昵称, createdTime=Thu Dec 11 15:12:00 CST 2014, time=2014-12-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=9115, encodeId=f90391157e, content=管过一例巨大脑膜瘤的17岁男患,学习第一,术后也非常好,这样的病例比较少见!, beContent=null, objectType=article, channel=null, level=null, likeNumber=244, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b4977922, createdName=faustine, createdTime=Wed Apr 23 18:47:00 CST 2014, time=2014-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280819, encodeId=747e1280819f5, content=<a href='/topic/show?id=a55385062c7' target=_blank style='color:#2F92EE;'>#脑膜瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85062, encryptionId=a55385062c7, topicName=脑膜瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Sat Mar 08 04:12:00 CST 2014, time=2014-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1630716, encodeId=21581630e167d, content=<a href='/topic/show?id=50b59e9687e' target=_blank style='color:#2F92EE;'>#附属医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97968, encryptionId=50b59e9687e, topicName=附属医院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c2a721567074, createdName=tongyongming, createdTime=Sat Mar 08 04:12:00 CST 2014, time=2014-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1764087, encodeId=05671e640871f, content=<a href='/topic/show?id=d76d9102e83' target=_blank style='color:#2F92EE;'>#解放军总医院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91027, encryptionId=d76d9102e83, topicName=解放军总医院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cf5837624055, createdName=12498b08m102暂无昵称, createdTime=Sat Jan 03 03:12:00 CST 2015, time=2015-01-03, status=1, ipAttribution=)]
    2014-04-23 faustine

    管过一例巨大脑膜瘤的17岁男患,学习第一,术后也非常好,这样的病例比较少见!

    0

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