{"nowTime30":1780233486810,"lyBarModerator":null,"metaSearch":{"description":"　　目前对胶质瘤医学上还缺乏有效的根治手段，术后患者身体虚弱要补充营养，对患者不能一概而论，要注意饮食不慎或忌口不严导致病情复发。患者能吃什么?不能吃什么?这是患者及家属非常关心的问题之一，要因人、因地、因时而异，要辨病、辨证而定。　　一、胶质瘤患者需常吃的五种食物　　1、芦笋　　芦笋是一种抗癌很好","keywords":"胶质瘤患者需常吃的五种食物_洞医","title":"胶质瘤患者需常吃的五种食物_洞医","channels":null},"identificate":{"id":"5e13ee2eec7311e6a61c00163e04584d","isDel":0,"createAt":1486389092508,"createBy":"6f08827db09911e6927f00163e04584d","createName":"海总剑客","updateAt":0,"updateBy":null,"updateName":null,"userId":"6f08827db09911e6927f00163e04584d","realName":"sdafsdf","certifiedStatus":2,"phone":"sadfasdfasdfsdf","email":"756954943@qq.com","hospitalId":"30cb97bf453011e69d4700163e005165","departmentId":"2000","illName":"","illId":"793a72a2bb5f11e6a61c00163e04584d","cardType":1,"cardImg":"http://01luntan.com/ly_img/1486826616752.jpg","idCardImg":"","identityType":2,"stop":0,"departmentName":"儿科","hospitalName":null},"canEdit":null,"adList":[{"id":"ba12d7c45aea11eaa47600163e0462f1","isDel":0,"createAt":1582977477879,"createBy":"sys","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"name":"【胶质瘤解密】解放军总医院精彩讲解","image":"http://www.01luntan.com/ly_img/admin-fa032a53-837b-467e-b160-dd56aaeaa43f.jpg","url":"https://item.taobao.com/item.htm?spm=a2oq0.12575281.0.0.25911debW42Sos&ft=t&id=572617349581","type":2,"webType":2,"sortNo":5,"dataRelType":1,"dataRelId":"1337"},{"id":"c4666b855aed11eaa47600163e0462f1","isDel":0,"createAt":1582978783698,"createBy":"sys","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"name":"儿童胶质瘤病友群","image":"http://www.01luntan.com/ly_img/admin-3858f059-5da0-4909-a424-7643e13285c7.png","url":"https://jq.qq.com/?_wv=1027&k=52CVy5l","type":2,"webType":2,"sortNo":4,"dataRelType":1,"dataRelId":"1337"},{"id":"fea362e65aed11eaa47600163e0462f1","isDel":0,"createAt":1582978881401,"createBy":"sys","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"name":"四级别胶质瘤病友群","image":"http://www.01luntan.com/ly_img/admin-4913ab79-2043-46fc-a414-16a42dfa7ffc.png","url":"https://jq.qq.com/?_wv=1027&k=59WG3X0","type":2,"webType":2,"sortNo":3,"dataRelType":1,"dataRelId":"1337"},{"id":"2c8d1cf55aee11eaa47600163e0462f1","isDel":0,"createAt":1582978958433,"createBy":"sys","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"name":"三级胶质瘤病友群","image":"http://www.01luntan.com/ly_img/admin-ceb2db2b-f723-45ee-9020-0696492faaab.png","url":"https://jq.qq.com/?_wv=1027&k=5Mb7kti","type":2,"webType":2,"sortNo":2,"dataRelType":1,"dataRelId":"1337"},{"id":"70cc5e055aee11eaa47600163e0462f1","isDel":0,"createAt":1582979072932,"createBy":"sys","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"name":"低级别胶质瘤病友群","image":"http://www.01luntan.com/ly_img/admin-77ff1e91-0d73-4ed5-a62b-6d0e300746ab.png","url":"https://jq.qq.com/?_wv=1027&k=51qVSBp","type":2,"webType":2,"sortNo":1,"dataRelType":1,"dataRelId":"1337"}],"lyBar":{"id":"1337","isDel":0,"createAt":1483430657181,"createBy":"system","createName":"system","updateAt":0,"updateBy":null,"updateName":null,"userId":null,"name":"胶质瘤","type":102,"twoCode":"http://zhao01.com/zly_img/zly_wx.jpg","image":null,"provinceId":null,"cityId":null,"illId":"6a325ddbbb5f11e6a61c00163e04584d","hospitalId":null,"keyWord":null,"totleTopic":0,"barDesc":null,"discussBarType":null,"metaSearch":"{\"channels\":{\"病友社区\":{\"description\":\"为病友提供:中医胶质瘤论坛_病友交流平台坛，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"中医胶质瘤论坛_病友交流平台_病友论坛\",\"title\":\"中医胶质瘤论坛_病友交流平台_病友论坛\"},\"治疗\":{\"description\":\"为您提供:病友的治疗经验等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"胶质瘤怎么治疗_胶质瘤保守治疗_胶质瘤治疗方法\",\"title\":\"胶质瘤怎么治疗_胶质瘤保守治疗_胶质瘤治疗方法\"},\"症状\":{\"description\":\"为您提供:质瘤复发的症状_胶质瘤早期症状_胶质瘤的症状有哪些等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"质瘤复发的症状_胶质瘤早期症状_胶质瘤的症状有哪些\",\"title\":\"质瘤复发的症状_胶质瘤早期症状_胶质瘤的症状有哪些\"},\"并发症\":{\"description\":\"为您提供:胶质瘤术后并发症_胶质瘤术后后遗症_胶质瘤手术后遗症等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"胶质瘤术后并发症_胶质瘤术后后遗症_胶质瘤手术后遗症\",\"title\":\"胶质瘤术后并发症_胶质瘤术后后遗症_胶质瘤手术后遗症\"},\"饮食\":{\"description\":\"为您提供:胶质瘤饮食禁忌_胶质瘤病人饮食_胶质瘤吃什么好等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"胶质瘤饮食禁忌_胶质瘤病人饮食_胶质瘤吃什么好\",\"title\":\"胶质瘤饮食禁忌_胶质瘤病人饮食_胶质瘤吃什么好\"},\"病因\":{\"description\":\"为您提供:胶质瘤怎么引起的_胶质瘤怎么形成_胶质瘤怎么得的等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"胶质瘤怎么引起的_胶质瘤怎么形成_胶质瘤怎么得的\",\"title\":\"胶质瘤怎么引起的_胶质瘤怎么形成_胶质瘤怎么得的\"},\"病友求助\":{\"description\":\"为您提供:胶质瘤有治愈的吗_胶质瘤早期能治好吗_良性胶质瘤能治好吗等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"胶质瘤有治愈的吗_胶质瘤早期能治好吗_良性胶质瘤能治好吗\",\"title\":\"胶质瘤有治愈的吗_胶质瘤早期能治好吗_良性胶质瘤能治好吗\"},\"预防\":{\"description\":\"为您提供:吃什么预防胶质瘤_怎么预防胶质瘤_如何预防胶质瘤等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"吃什么预防胶质瘤_怎么预防胶质瘤_如何预防胶质瘤\",\"title\":\"吃什么预防胶质瘤_怎么预防胶质瘤_如何预防胶质瘤\"}},\"description\":\"为您提供:脑部胶质瘤病因_脑部胶质瘤能活多久_脑胶质瘤症状早期症状_胶质瘤病友的治疗经验等相关信息，让病友在便捷的求医路上不花一分冤枉钱。\",\"keywords\":\"脑部胶质瘤病因_脑部胶质瘤能活多久_脑胶质瘤症状早期症状\",\"title\":\"脑部胶质瘤病因_脑部胶质瘤能活多久_脑胶质瘤症状早期症状\"}","adInfo":null},"isLikeThisTopic":null,"lastTopics":[{"id":"1349","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"upda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　　随着社会的发展，胶质瘤发病率呈逐渐上升的趋势，据统计脑胶质瘤所致的死亡远超过急性淋巴细胞白血病，找出脑胶质瘤危险因素对预防具有重要意义。

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　　1、养成良好的生活习惯，戒烟限酒。

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　　2、不过多地吃咸而辣的食物，不吃过热、过冷、过期及变质的食物;年老体弱或有某种疾病遗传基因者酌情吃一些防癌食品和含碱量高的碱性食品，保持良好的精神状态。

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　　3、有良好的心态应对压力，劳逸结合，不要过度疲劳。中医认为压力导致过劳体虚从而引起免疫功能下降、内分泌失调，体内代谢紊乱，导致体内酸性物质的沉积;压力也可导致精神紧张引起气滞血淤、毒火内陷等。

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　　4、不要食用被污染的食物，如被污染的水、农作物、家禽鱼蛋、发霉的食品等，要吃一些绿色有机食品，防止病从口入。

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　　5、加强体育锻炼，增强体质，多在阳光下运动，多出汗可将体内酸性物质随汗液排出体外，避免形成酸性体质。

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　　求医网温馨提示：生活中拒绝食用一些被污染的食物，如被污染的水，农作物，家禽鱼蛋，发霉的食品等，要多吃一些绿色有机食品，防止病从口入。

\n

 

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胶质瘤术后饮食要怎么改善，也成了胶质瘤患者及家属头疼的问题，胶质瘤患者术后身体会比较虚弱，可以适当的补充一些营养物质，比如说优质蛋白质、牛奶等进行补充。还可以多吃些绿色蔬菜水果，增加维生素，真菌类食物也是比较适合胶质瘤患者食用的，益肾补脑的多吃一些，还有就是黑芝麻、何首乌、杭菊、深海产品等，这些食材都是在平时可以经常吃的，也是可以提高身体的抵抗力和免疫力的东西，但是千万记得不要大补，大补对他很不利。平时要禁忌咖啡，刺激辛辣食物，禁忌使兴奋的饮料，发霉、烧焦、腌制品都是不能吃，禁忌烟酒等等，这些都是胶质瘤术后饮食上需要改善的地方。除了饮食上的改善外，还可以进行适当的身体锻炼，增强自身体质，这个也是很重要的一个预防内容，一个强壮的身体是抵抗肿瘤非常好的武器，能大大增加患者的生存期。

\"胶质瘤术后饮食怎么改善\"

上图是解放军总医院第一附属医院傅相平写的《脑胶质瘤解密》，希望能帮到更多的患者，同时胶质瘤解密总群成立，傅相平教授也会定期在群里为大家免费解答疑惑，患者或者患者家属也可以在群里互相讨论，全程不收取任何费用哦。

\"胶质瘤术后饮食怎么改善\"

","barId":"1337","topicTypeId":null,"topicThemeId":"1035","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":6},{"id":"11365","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"胶质瘤发病部位不同症状也不尽相同","content":"

\"胶质瘤发病部位不同症状也不尽相同\" 

 

胶质瘤根据肿瘤程度不同，一般分四级，级数越高，恶性程度越高，决定肿瘤生长速度的快慢、症状出现的早晚和预后效果，会出现以下不同的情况，找良医网带大家一起来学习一下：

 

一、胶质瘤不同部位的症状

 

1、中脑肿瘤

该病症是由于出现肿瘤而阻塞导水管，在早期可出现颅内压增高症状。也有首发症状为精神和智力改变，这可能与网状结构受累有关。

 

2、桥脑肿瘤

该症状多见于儿童，占全部脑干肿瘤半数以上。早期儿童常以复视、易跌跤为首发症状;成年人则常以眩晕、共济失调为首发症状。90％以上病人有颅神经麻痹症状，约40％病人以外展神经麻痹为首发症状，随着肿瘤发展出现面神经、三叉神经等颅神经损害和肢体的运动感觉障碍。

 

3、延髓肿瘤

首发症状常为呕吐，易被误诊为神经性呕吐或神经官能症，特别是成年患者。病人可有不同程度头昏、头痛，然后较早出现后组颅神经麻痹的症状，症状如吞咽困难、进食呛咳、讲话鼻音、伸舌不能等。

 

二、胶质瘤常见症状

 

1、眼球不能上视

因颅压增高可使患儿出现双侧眼球内斜视，俗称“对眼”或“斗鸡眼”。还有的患儿逐渐出现眼球不能往上看，也预示着脑内松果体区存在肿瘤的可能。

 

2、复视

就是我们常说的看东西两个影子，重影等，这是因颅压增高导致外展神经不完全麻痹引起。

 

3、头颅增大

多发生在婴幼儿，因此期小儿颅缝未愈合或愈合不紧，颅内压增高可致颅缝分离而使头围增大。这种头颅增大常不如先天性脑积水明显。

 

4、眼歪口斜伴有走路不稳

该症状经常提示，可能为脑干胶质瘤。

 

5、意识障碍或精神异常

严重意识障碍(如昏迷或半昏迷等)常为脑疝所致，而颅压增高严重的患儿可表现为淡漠、乏力及嗜睡等，需引起留意。据找良医网统计的国外资料显示，儿童脑瘤患者有人格改变者约占半数，有行为异常者约占到50％左右。多数表现为呆滞，对玩耍不感兴趣，易疲乏，沉静寡言或易激怒。

 

6、头痛

多数头痛为颅内压增高所致，少数病例可因肿瘤直接刺激硬脑膜而出现局限性头痛。

 

　找良医网温馨提示：胶质瘤可导致患者死亡，对于患者而言，应该对病情有一定的了解，这样才能随时清楚的认识自己身体状况，进行相应的预防措施。最后，找良医网祝大家能早日康复，有个好身体！

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女,51岁。头晕的情况有2年左右了，一年前去医院拍ct也没看出来问题只是说血脂稠，吃着给血脂降稠的药没事断了药两天就会出现头晕，半个月之前晚上起来去方便晕倒在地，随后做了磁共振怀疑肿瘤，做了手术摘除了病灶到今天14天了终于可以开口说话了，目前的情况是右侧肢体没力，能听懂刚刚会说话了 说的慢不清楚，小便控制的不好，(提一下，手术中的冰冻切片病理是胶质增生，大病理是二级少突胶质瘤)我想问问这都是正常现象吗？都会慢慢恢复吗？

","barId":"1337","topicTypeId":null,"topicThemeId":"1033","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"3263","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"胶质瘤不头疼是好情况吗，这种情况算是早期吗，","content":"

男,49岁。不头疼，不呕吐，只是右手不太受控制，不听使唤，但手有劲，去北京天坛医院检查，说是胶质瘤，但不知道严重程度。 
，病情发生到现在还不到一周。

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","barId":"1337","topicTypeId":null,"topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":5},{"id":"2296","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"椎管内神经节细胞胶质瘤","content":"

　临 床 资 料

　　患儿：女，5岁。因双下肢无力，行走困难1年半入院。

　　体检：t 36.7 ℃，r 18次/分，bp 105/75 mmhg(14/10 kpa)神清，营养中等，双下肢被动体位，未及肿大的浅表淋巴结，头无畸形，瞳孔等大等圆，对光反射存在，颈软，甲状腺不大，胸廓对称，心音有力，律齐，hr 84次/分，未及病理性杂音，腹部未及肿块和压痛。

　　骨科情况：双下肢不能行走，仅能扶物蹲坐，肌张力增高，但肌力减弱，左下肢ⅲ级，右下肢ⅱ级，感觉自腹股沟平面以下减退，膝、跟腱反射亢进，踝阵挛阳性，巴氏征阳性。大、小便能自控。

　　实验室检查：wbc 8.6×109/l，hb 156 g/l，血钙2.45 mmol/l(正常值2.03～2.54 mmol/l)，磷1.6 mmol/l(正常值1.0～1.6 mmol/l)，碱性磷酸酶1.837 μmol.s-1.l-1［旧制110 iu(正常值34～86 iu)］。

　　x线平片：t7～12椎体骨质密度增高，间隙存在，左侧有一弧形软组织阴影。

　　mri检查：t6～l1左侧前方巨大占位性病变并累及椎管内(t9～12)和背部软组织。

　　门诊诊断为：① 椎管内肿物；② 不完全截瘫。经充分准备，在全麻下行椎管内探查、减压术，术中见：在暴露椎板时，左侧软组织内可见结构异常之肿物，约2 cm×1.5 cm大小，包膜完整，不活动。进入椎管后见压力较大，肿物包绕硬脊膜囊长约7 cm，且有部分粘连，尽量切除肿物，切除物质地较硬，呈灰黄色，有包膜，切除肿物时出血较多。

　　讨　　论

　　马建东医师：

　　患儿病史时间较长，且出现脊髓受压表现，影像学显示椎管内、外均有肿块，病变范围较长，椎管外肿物很可能是来自后纵隔，常见淋巴系统、神经系统肿瘤，但很少侵犯到椎管内；而椎弓根的不完整性，双侧肋横关节不对称，以及胸段有脊柱左侧凸的被动体位均支持椎管内肿物向外发展的表现，并由手术证实，髓外硬膜外肿瘤通常以转移瘤或淋巴瘤多见，发生于硬膜外的罕见恶性肿瘤还有恶性纤维组织细胞瘤。在良性肿瘤中室管膜瘤、脂肪瘤、神经鞘瘤或脊膜瘤也发生在硬膜外，在儿童，神经母细胞瘤也可造成硬膜外受累。

　　病历中提示肿物有包膜，应属良性，但病变范围大，生长慢，肿物又包绕硬膜囊，有部分粘连，可能又是低恶性度肿瘤，所以诊断为：① 室管膜瘤；② 神经鞘瘤。

　　李开静医师：

　　该患儿表现为脊髓上运动神经元损害，而出现的痉挛性不完全截瘫。影像学检查以及手术所见提示既有骨质的改变，也有软组织的改变。骨质的改变以多椎体的硬化为主。软组织的改变是以椎内、外多发肿瘤为主。术中未见脊髓本身的病变，只见脊髓被肿物包绕，椎管内压力增高。说明患儿的症状和体征是由于脊髓被肿物压迫引起。而在椎管内外，多发的软组织肿物有神经鞘瘤、骨脂肪瘤、脊髓胶质瘤、神经纤维瘤等。而本例首先考虑神经鞘瘤。该病的特点是在发病部位在脊椎管内，可以复发，病程长，可以引起腰腿痛，感觉运动障碍，甚至截瘫。其次考虑脂肪瘤，易发生于儿童，可以出现巨大的软组织包块，隐匿发病，压迫神经时才出现症状。

　　蔡迎医师：

　　由mri表现看诊断为椎管内肿物。但判断了有椎管内肿物还不够，还应做出肿瘤的节段性定位，并要做好髓内和髓外肿瘤的鉴别诊断，以及椎管内肿物与其他病变的鉴别诊断。首先由查体发现自腹股沟平面以下感觉减退，脊髓病变受压平面在t12，与x线、mri的所见相符。而根据肿瘤所在脊柱局部解剖构造(regional components rc)分类，椎管内肿物又分为髓内病灶、硬膜内髓外病灶、硬膜外病灶，后二者又可统称为髓外病灶，这其中以硬膜内髓外病灶为最常见。由术中所见，肿物位于硬膜囊外，为髓外病灶。而髓外病灶与髓内病灶在许多方面是有显著区别的。本病例中病史1年半，说明病程较长，症状时轻时重；括约肌功能没变化，上述表现均支持髓外病变而基本排除髓内病变。再谈与其他疾病的鉴别，小儿脊柱疾病中以结核最多见，而本例一般情况好，hb 156 g/l以及平片没见椎体破坏，椎间隙狭窄及椎旁脓肿，可以排除骨结核。综上所述，本病诊断为椎管内肿物且为髓外病变。而髓外病变的肿瘤性质又以神经纤维瘤及脊膜瘤最多见，所以考虑：① 神经纤维瘤；② 脊膜瘤。

　　刘志刚医师(放射科)：

　　由平片见胸椎左侧有软组织肿物影。t9～11椎体左侧有弧形压迹，左侧第7～11肋骨有弧形压迹。椎弓根受压，t9～11椎管横径加大。

　　该肿物为后纵隔肿物，最常见的为神经源性肿物，此外还有降主动脉瘤、后纵隔囊肿、骨结核、骨髓炎，x线平片显示椎体无骨破坏、无硬化、无椎旁脓肿，可以排除骨结核、骨髓炎，而肿物边缘光滑、密度高，又可以排除主动脉瘤和后纵隔囊肿。mri表现椎管内外有“哑铃形”密度均匀一致的肿块，影像学诊断为脊膜瘤。

　　王瑞林医师(病理科)：

　　标本肉眼检查：送检标本为灰褐色、结节状及片状组织数块，大小3.5 cm×0.8 cm。

　　镜检：肿瘤包膜不完整，肿瘤组织由两种肿瘤细胞构成：① 肿瘤性神经元，细胞体积较大，胞浆丰富，呈索条状或小片状分布，核大，染色质细，有明显核仁，多见双核、三核、四核细胞；② 肿瘤性星形(胶质)细胞，核小、卵圆或短梭型，核两端可有长的、红染、纤细的胞浆突起，肿瘤细胞突起互相交织；上述两种肿瘤细胞之间穿插有多量神经纤维，部分可见髓鞘结构。

　　病理诊断：神经节细胞胶质瘤(ganglioglioma)。

　　组织起源：可能来自背神经节或胚胎发生过程中迷离、残留组织。

　　张质彬医师：

　　本病例讨论会我们打了一个小埋伏。1991年4月家长无意中发现左腋后线中段处有一皮下结节，无任何症状，未予重视。3个月后行走不稳易跌跤，就诊本市多家医院，认为是脑部疾患而行ct检查，未发现异常。1991年10月，在市儿童医院摄胸片发现有纵隔肿瘤并侵及胸椎管内。给予mri检查，诊断为：“神经纤维肉瘤”。此期间患儿步行困难加重，家长求治于中医，服药4个多月，步行好转。1992年6月因“受凉”，行走困难复发，就诊本市胸科医院行上述皮下结节病理切片检查，提示为良性肿瘤。1992年10月胸科医院行纵隔肿物切除术。术中发现，开胸后纵隔有鸽卵大小，圆形硬韧肿物4～5个，因与大血管关系密切，故未切除。左横隔膜有4 cm×6 cm肿物，切除2/3。术后病理报告为节细胞神经肿瘤。开胸手术4个月后来我院。以椎管内肿物于1993年2月10日入院。

　　入院后查体见患儿痉挛性瘫加重，左足心有1.5 cm×1.5 cm大小咖啡斑，入院目的主要是椎板减压。

　　手术切口由t6～12，暴露椎板，左侧背伸肌中有结构异常之肿物2 cm×1.5 cm，有包膜，不活动，完整切除。咬除t8～11椎板，见椎管内压力较大，肿物包绕硬膜囊涌出，长7 cm，硬膜囊表面暗紫色，失去搏动，尽量切除肿物，肿物较韧呈灰黄色，有包膜，左侧肿瘤穿过椎板与胸腔相通，故停止手术，肿物送病理。切除肿物后硬膜囊缓慢变成灰色并可见到微弱的脊髓搏动。术后5年余来院复查，仍有下肢痉挛，但步态基本正常，蹲起自如，家长讲病情逐渐在恢复，向好的方向发展。但胸椎下段、左侧椎旁肿物约6 cm×6 cm。

　　戴祥麒医师：

　　椎管内肿物比较少见，多为良性。此次讨论病例是提醒临床骨科医生对存在脊髓神经症状时应考虑到此病的可能。通过讨论进一步认识常见的几种椎管内肿瘤的特点。

　　最后提示是：早期手术，应做到尽量彻底。如何达到这点，必须将椎板切除，见到正常硬膜，才能看到肿瘤边界。然后用硬膜剥离器沿硬膜剥离，就会较为完整的分离，较彻底地切除。一般情况下椎管内硬膜外的肿瘤完全侵犯脊髓、使肿瘤与脊髓成为一体的可能太小。若看不到正常硬膜，就是暴露还不够，应继续切除椎板。

　　神经节细胞胶质瘤多见于30岁以下年轻人，儿童稍多，其发病率约占中枢神经系统肿瘤的4.5%～7.6%。多见于大脑脑干、基底结核团，亦可见于外周交感神经节。典型者肉眼呈灰白、灰红色，质稍硬，可有或无包膜、界限清楚、可有囊性变或钙化，镜下可见两种肿瘤成分：神经节细胞分布不规则，细胞为单核、双核或多核、胞浆可见尼氏体，混杂有髓鞘和无髓鞘神经纤维；间质混有胶质细胞，多为星型细胞，细胞形态有异型性。免疫组织化学染色胶质细胞呈gfap阳性；神经节细胞呈nf、nse、synaptophysin及chromogranin a阳性。电镜观察见肿瘤性神经节细胞内有颗粒、突触前小泡和突触结构。

　　鉴别诊断：此瘤需与发生在脊椎管内、外的一些常见肿瘤区别。归纳如下：

　　1. 神经鞘瘤：为脊椎管最常见肿瘤，多见于30～50岁成年人，肿瘤位于脊髓外、硬膜内。多来自脊神经的感觉根，肿瘤位于脊髓的背侧或背外侧，多位于脊髓胸、腰段。肿瘤质软，血运丰富，可挤压脊髓和硬膜，肿瘤由外向内压，边界清楚，镜下呈antoni a型栅状排列或antoni b型网状结构，肿瘤组织不包裹神经根。

　　2. 脑(脊)膜瘤：为脊椎管常见肿瘤。起源于蛛网膜上皮，多见于40～60岁成年人，胸段最常见，位于脊髓外、硬脊膜下腔，常和硬脊膜粘连密切，脊髓侧边界清晰，肿瘤质硬、韧、包膜完整，血运中等，镜下分型为脑膜内皮细胞型、纤维母细胞型、过渡型、沙粒体型及血管瘤型。

　　3. 神经纤维瘤：此瘤硬膜外多见，常在椎管内和脊柱旁软组 织内生长。可呈哑铃型，常包裹神经纤维。镜下见瘤细胞细长，扭曲，瘤组织呈波浪状结构。

　　4. 室管膜瘤：多见于20岁以下儿童和青少年。此瘤占脊髓胶质瘤的60%，肿瘤起自脊髓内、大小不一、边界不清晰呈浸润性生长。此肿瘤不侵犯硬膜。镜下分为室管膜上皮型、乳头型和粘液乳头型及细胞型等亚型。

　　5. 恶性淋巴瘤：常位于硬膜外、边界不清晰，肿瘤质软呈鱼肉状，沿硬膜外间隙生长。镜下以非何杰金恶性淋巴瘤多见。


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\"专家告诉您胶质瘤病因有哪些\"

 

在本文中，找良医网带大家了解一下胶质瘤的发病原因是什么，从医学学术上讲，是怎样的情况？接下来一起看一下：

 

据专家研究统计，目前关于神经母细胞瘤真正的病因尚不清楚。一些遗传易感因素被发现与神经母细胞瘤的发病相关。家族型神经母细胞瘤被证明与间变淋巴瘤激酶的体细胞突变所导致。此外，在神经母细胞瘤还发现有许多分子突变。N-myc基因的扩增突变在神经母细胞瘤也很常见。其扩增类型呈双向分布：在一个极端为3-10倍扩增，在另一个极端为100-300倍扩增。N-myc基因的扩增突变往往与肿瘤的扩散相关。LMO1基因被证明与肿瘤的恶性程度相关。

 

这种病症由于神经母细胞瘤往往发生于婴幼儿，因此有许多研究集中调查环境危险因素对怀孕以及孕期的影响。例如怀孕期间的是否接触化学危险品、吸烟、饮酒、药物、感染等。但是，这些研究尚未有明确的结果。

 

找良医网温馨提示：如有身体不适，请及时就医！

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\"胶质瘤患者需常吃的五种食物\"

下载二维码微信识别，观看傅相平教授主讲《脑溢血解密》，看完对这个病就完全明白了

\"胶质瘤患者需常吃的五种食物\"

欢迎扫描二维码加入QQ群，听听病友们怎么说，听听医生怎么说


","floor":1,"isAdopt":0,"type":0}],"list4Map":null,"pageBegin":0,"pageSize":5,"pageNumber":1,"totalPage":1,"totalRow":1},"loginUser":null,"replies":[{"id":"4fd871cd5dfa11e9972100163e0462f1","isDel":0,"createAt":1555166527421,"createBy":"84404015eff611e6a61c00163e04584d","createName":"13911686944","updateAt":0,"updateBy":null,"updateName":null,"userId":"84404015eff611e6a61c00163e04584d","targetUserId":null,"topicId":"3907","replyPid":null,"reply":"

\"胶质瘤患者需常吃的五种食物\"

下载二维码微信识别，观看傅相平教授主讲《脑溢血解密》，看完对这个病就完全明白了

\"胶质瘤患者需常吃的五种食物\"

欢迎扫描二维码加入QQ群，听听病友们怎么说，听听医生怎么说


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