妊娠合并颅内海绵状血管瘤临床分析及文献回顾

目的探讨妊娠合并颅内海绵状血管瘤的临床特征、妊娠对颅内海绵状血管瘤的影响、终止妊娠的时机、分娩方式的选择、再次妊娠颅内出血的风险。方法以2015年9月~2017年3月期间,我院收治的妊娠合并颅内海绵状血管瘤5例为研究对象,回顾性分析患者的年龄、临床特征、治疗方法、终止妊娠的时机、分娩方式的选择。结果临床特征:妊娠合并颅内海绵状血管瘤患者多无症状,常见临床表现是癫痫及颅内出血。终止妊娠时机:5例均在妊娠36周以后终止妊娠。分娩方式选择:5例均选择剖宫产终止妊娠。结论妊娠合并颅内海绵状血管瘤临床少见,对于其终止妊娠的时机及分娩方式的选择目前缺乏大样本研究,有待多学科协作,进一步研究,规范治疗,以改善患者预后。

Clinical analysis and literature review of pregnancy combined with cavernous cerebral malformations

Objective To investigate the clinical characteristics of pregnancy combined with cavernous cerebral malformations,the effect of pregnancy on cavernous cerebral malformations,the timing of termination of pregnancy,the selection of mode of delivery,and the risk of repeated intracranial hemorrhage during pregnancy.Methods A total of 5 cases of pregnancy combined with intracranial cavernous hemangioma who were admitted to Beijing Tiantan Hospital from September 2015 to March 2017 were selected as the study subjects.Retrospective analysis was carried out for the patients''age,clinical characteristics,treatment methods,the timing of termination of pregnancy,and the selection of mode of delivery.Results Clinical characteristics:the patients with pregnancy combined with cavernous cerebral malformations were mostly asymptomatic,with the common clinical manifestations of epilepsy and intracranial hemorrhage.Timing of termination of pregnancy:5 cases received termination of pregnancy after 36 weeks of labor.The selection of mode of delivery:5 cases selected cesarean section to terminate pregnancy.Conclusion Pregnancy combined with cavernous cerebral malformations is rare.For the timing of its termination of pregnancy and the selection of mode of delivery,a large sample study is currently lacking,which needs multi-disciplinary collaboration,further study,and standardization of treatment,so as to improve the prognosis of patients.