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目的 探讨中枢神经系统副神经节瘤的诊断和治疗特点。 方法 1976～ 1999年手术治疗 17例副神经节瘤 ,其中颈静脉球瘤 11例 ,椎管内转移性副神经节瘤 2例 ,颈动脉体瘤、鞍区副神经节瘤、颞骨副神经节瘤及顶叶转移性副神经节瘤各 1例。术中采用系统动脉压降压 3例 ,亚低温麻醉 1例 ;术前行血管内栓塞治疗 7例 ;术后联合普通放疗 5例 ,联合γ 刀治疗 2例。 结果 肿瘤全切除 11例 ,次全切除 3例 ,大部切除 3例。术后 10d死亡 1例 ,远期随访 6个月～ 6年 ,1例格拉斯哥预后评分 (GOS) 3分 ,其余均 4～ 5分。 结论 临床表现结合影像学特点有助于临床诊断。手术全切除肿瘤为治疗首选方案 ,术后复发率低 ;术前栓塞应作为常规辅助治疗 ,可有效控制术中出血 ;术后放射治疗可控制残留肿瘤的生长。
Objective To investigate the diagnosis and treatment of paraganglioma in the central nervous system. Methods Seventeen cases of paraganglioma were treated surgically from 1976 to 1999, including 11 cases of jugular bulboma, 2 cases of metastatic paraganglioma, 2 cases of carotid body tumor, sella ganglia, Tumor and parietal metastatic paraganglioma in 1 case. Intraoperative arterial blood pressure in patients with hypertension in 3 cases, hypothermia anesthesia in 1 case; preoperative endovascular embolization in 7 cases; combined with conventional radiotherapy in 5 cases, combined with gamma knife treatment in 2 cases. Results Total resection in 11 cases, subtotal resection in 3 cases, most resection in 3 cases. One patient died at 10 days after operation and was followed up for 6 months to 6 years. One patient had a Glasgow Prognosis Score (GOS) of 3 and the remaining 4 to 5. Conclusion Clinical manifestations combined with imaging features help clinical diagnosis. Surgical resection of the tumor for the treatment of choice, postoperative recurrence rate is low; preoperative embolization should be used as a routine adjuvant therapy, which can effectively control intraoperative bleeding; postoperative radiotherapy can control the growth of residual tumor.