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鲍圣德, 鲍圣德*, 浦佩玉, 薛庆澄, 王燕复, 胡自正
中华神经外科杂志,1992,8(1):021~024,-0001,():
-1年11月30日
本文报告并分析了5例脑膜增对性激素反应的体外试验结果。试验表明。雌二醇及孕酮均可刺激肿瘤生长,但生理浓度下孕酮的刺激作用较雌二醇强,这与瞄膜瘤孕激素受体(PR)占优势的特点一致孕激素拈抗剂Ru486有明显的抑镧肿瘤生长作甩。本文为瞄膜瘤的激素治疗提供了一定的实验依据,其中应以抗孕激豢治疗为主,RU486可能有潜在的临床治疗意义。
脑膜肿瘤, 雌二醇, 孕激素类
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鲍圣德, 尤玉才, 张建国△, 俞光岩△, 王象昌, V. Seifert△△
北京医科大学学报,1998,30(2):174~176,-0001,():
-1年11月30日
目的:探讨一种切除中颅凹-颞下凹沟通肿瘤的颅-面联合入路。方法:采用经额颞颧下颌联合手术入路切除肿瘤。结果:显微镜下全切肿瘤的患者经远期随访无神经系统症状及体征。结论:该入路暴露充分,对脑组织牵拉小,能在颈部控制颈内、外动脉,尽早辨认并保护面神经,对切除中颅凹-颞下凹沟通肿瘤十分有利。
脑肿瘤/, 外科手术, 颅神经肿瘤/, 外科手术, 颞叶/, 外科手术, 显微外科手术
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鲍圣德, V. Seifert△, F.M. Van Krieken△, D. Stolke△
北京医科大学学报,1998,30(1):64~66,-0001,():
-1年11月30日
目的:提高对后颅凹脑膜瘤诊断与治疗的认识。方法:对1987~1993 年收治、显微手术切除的45例后颅凹脑膜瘤病例进行回顾性分析。结果:肿瘤全切29 例(29/45)。疗效:优27例(27/45),良8例(8/45),差5例(5/45),死亡5例(5/45)。结论:术前精确的诊断对手术及预后非常重要。手术入路主要取决于肿瘤的位置、延伸和大小。统计学分析表明病人的预后与术前ASA(美国麻醉学会评分法)级别和术前神经功能状况有关。
颅凹,, 后, 脑膜瘤/, 诊断, 脑膜瘤/, 外科手术, 预后
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鲍圣德
中华神经外科杂志,1998,14(5):269~272,-0001,():
-1年11月30日
目的:介绍并讨论一种处理斜坡及斜坡旁区肿瘤及血管病变经岩骨手术入路。方法:对28例病人实施了乙状窦前2迷路后经岩骨幕上下联合入路手术。结果:显微镜下肿瘤全切率82%,3例桥脑内海绵状血管瘤全部切除,3例基底动脉瘤均成功夹闭。术后4例出现暂时性颅神经损伤症状,1例出现永久性动眼神经损伤症状。颅神经损伤发生率为18%。2例术后脑脊液漏,2例术后死亡,其余病人恢复良好并均保留了听力。结论:该手术入路的主要优点:对小脑及颞叶牵拉轻;可缩短到达斜坡的距离,并对斜坡区提供良好的暴露,可以保留耳蜗、面神经、横窦、乙状窦及Labbe 静脉等重要结构。
入路, 颅底, 斜坡肿瘤, 动脉瘤
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鲍圣德, V.Seifert, F.M. van Krieken, S.D. Bao, D.Stolke, and M.Zimmermann
Acta Neurochir (Wien) (1994) 131: 241-246,-0001,():
-1年11月30日
In this retrospective study, the results of surgery were examined in 25 patients, 65 years of age or older, suffcring from malignant tumour growth along the cervical spine. The group consisted of 17 men and 8 women. The mean age was 73 years, ranging from 66go 88 years. The pathology identified was medtastasis in 23 patients, and plasmocytoma in two. The tumour localization involved a single segment of the cervical spine in 12 patients, two segments in 8 pa-tients. three scgments in 4 patients, and four segments in one patient. Pre-operatively, 8 patients (32%) suffered solely from severe pain. 6 patients (24%) showed severe pain and radicular nerve compres-tion. 5 patients (20%) had incomplete parta or tetraparesis but were able to walk, and again 6 paticnts (24%) had incomplete para of tetraparesis, and were unable to wald. A multitude of accompanying systemic diseases was present in the majority of patients. Evaluation of the pcri-operative risk profile was parformed using the American Socicty of Anaesthesiology (ASA) Grading of Physical Status Score. Operation consisted of microsurgical tumour removal, usually in-corporationg a single or multi-level vertebrectomy, with radical epi-dural decompression, and grafting with bone cement followed by an ippropriate osteosynthesis. Of the whole cohort of patients treated, four patients were till alive at the time of the last follow-up evaluation. 21 patients did. Four patients died within seven days after surgery. The remaining 17 patients died during the follow-up period. All of these patients died from systemic spread of their primary cancer. The results of mrgery in terms of postoperative neurological outcome were as Fol-lows: 11 patients or 44% were improved by surgery. 7 patients (28%) were unchanged, three patients (12%) became worse, and four pa-tents (16%) died. With regard to functional outcome, 73% of the patients with severe pre-operative neurological deficits showed sig-inficant postoperative amelioration of symptoms. 19 patients became imbulatory until the final sage of their disease. It is concluded, that according to the results of this limited study, general nihilistic or purely conservative approach for the treatment of elderly patients suffering from secondary malignancy of the cer-vical spine is not justified. With proper patient sclection, aggressive mrgery leads to significant amelioration of pre-operatively existing neurological deficits and long-term ambulation in a considerable percentage of the patients.
Cervical spine, microsurgery, elderly patients, spinal mmour
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