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目的 探讨颅内转移瘤的临床表现及最合适的诊断和治疗方法。方法 对本院 86例颅内转移瘤的临床表现影像学特点及治疗进行研究分析。结果 男 >女 (1 .45∶1 )。平均年龄 (55 .1 6± 8.58)岁。临床表现 ;脑瘤型 56例 ,癫 型 1 4例 ,卒中型 8例 ,精神型 7例 ,脑膜脑炎型 1例。先发现转移灶 47例 (54 .6 % ) ,先发现原发灶再出现转移灶 39例 (45 .4 % ) ;单发灶 38例 (44.1 % ) ,多发灶 48例 (55 .9% )。幕上转移 73例 (84.9% ) ,幕下转移 1 1例 (1 2 .7% ) ,幕上幕下同时转移 2例 (2 .4 % ) ;手术治疗 42例 (其中术后放疗 37例 ) ,单纯化疗 7例 ,放疗加化疗 30例 ,γ -刀 7例。手术加放疗平均生存期 (1 1 .58± 3 .52 )月 ,放疗加化疗平均生存期 (7.2 7± 3 .0 8)月 ,γ -刀治疗平均生存期 (1 0 .1 4± 2 .72 )月 ,单纯化疗生存期 (3 .1 1± 2 .72 )月。结论 本病以中老年多见 ,临床表现以脑瘤型多见 ,肿瘤多见于幕上 :多发灶 >单发灶。增强CT及MRI(增强对比 )是最适诊断性检查。治疗以手术加放疗为首选 ,其次为放疗加化疗。
Objective To investigate the clinical manifestations of intracranial metastases and the most appropriate diagnosis and treatment. Methods The clinical manifestations and treatment of 86 cases of intracranial metastases in our hospital were studied and analyzed. Results Male> female (1.45: 1). The average age was (55.1 ± 8.58) years old. The clinical manifestations included 56 cases of brain tumor, 14 cases of epilepsy, 8 cases of stroke, 7 cases of psychosis and 1 case of meningoencephalitis. Forty-seven cases (54.6%) of the metastatic lesions were found firstly, and 39 cases (45.4%) of the metastatic lesions were found in the primary tumor, 38 cases (44.1%) had single lesion, 48 cases (55.9% ). There were 73 (84.9%) cases of supratentorial metastasis, 11 (12.7%) of them underwent supratentorial operations and 2 (2.4%) of them underwent supratentorial operations. Surgical treatment of 42 patients (37 postoperative radiotherapy) Seven cases were treated with chemotherapy, 30 cases were treated with radiotherapy and chemotherapy, and seven cases were treated with gamma knife. The average survival time of operation plus radiotherapy was (11.58 ± 3.52) months, and the mean survival time of radiotherapy plus chemotherapy was (7.27 ± 3.08) months. The mean survival time of γ - knife treatment was (10 ± 14 ± 2) .72) months, simple chemotherapy survival (3.11 ± 2.72) months. Conclusion The disease is more common in middle-aged and elderly patients, with clinical manifestations of multiple brain tumors, tumors more common in the curtain: multiple lesions> single lesions. Enhanced CT and MRI (enhanced contrast) is the best diagnostic test. Surgery plus radiotherapy for the treatment of choice, followed by radiotherapy and chemotherapy.