CAJ | 학술논문

目的分析小儿急性血肿型肺吸虫脑病的临床特点和诊治方法,探讨该型与其他类型的区别.方法回顾性分析16例急性血肿型肺吸虫脑病患儿的临床特点、诊断方法和治疗效果.结果 16例患儿均有高颅压症状,惊厥发作5例,肢体偏瘫或单瘫4例,合并肺部症状4例；流行病学史阳性14例；全部病例肺吸虫抗体检测阳性；CT检查发现单纯脑内血肿12例,伴蛛网膜下腔出血3例,伴脑梗塞1例,血肿以额叶、顶叶为主.手术开颅清除血肿11例,非手术治疗5例,所有病例均口服吡喹酮治疗4～6个疗程,随访2个月至2年,预后良好.结论小儿急性血肿型肺吸虫脑病与其他类型有较大差别,病程更短、病情更为危重；影像学检查易出现误诊、漏诊；治疗上更倾向于积极手术；规范治疗预后更好.
목적 분석소인급성혈종형폐흡충뇌병적림상특점화진치방법,탐토해형여기타류형적구별.방법 회고성분석16례급성혈종형폐흡충뇌병환인적림상특점、진단방법화치료효과.결과 16례환인균유고로압증상,량궐발작5례,지체편탄혹단탄4례,합병폐부증상4례；류행병학사양성14례；전부병례폐흡충항체검측양성；CT검사발현단순뇌내혈종12례,반주망막하강출혈3례,반뇌경새1례,혈종이액협、정협위주.수술개로청제혈종11례,비수술치료5례,소유병례균구복필규동치료4～6개료정,수방2개월지2년,예후량호.결론 소인급성혈종형폐흡충뇌병여기타류형유교대차별,병정경단、병정경위위중；영상학검사역출현오진、루진；치료상경경향우적겁수술；규범치료예후경호.
Objective To analysis the clinical characteristics,diagnosis and therapy of acute cerebral paragonimiasis (intracerebral hemotoma type) in children,and explore the difference between this type and other types.Methods Clinical data from 16 patients with acute cerebral paragonimiasis (intracerebral hemotoma type) were retrospectively analyzed.Results All the patients presented symptom of high intracranial pressure,among them 5 cases were associated with convulsion seizure,hemiparalysis or monoplegia was seen in 4 cases and pulmonary symptom in 4 cases; 14 cases of patients had history of eating omophagia crab or drinking pestilence water; positive blood paragonimus antibodies was found in all cases; intracerebral hemotoma were found in 12 cases via CT scanning,hemotoma associated with subarachnoid hemorrhage in 3 cases and cerebral infarction in 1 case.Most hemotoma located in frontal lobe and parietal lobe.Hematoma evacuation was carried out in 11 cases,remains undertook the conservative therapy.The praziquantel was orally administered for 4～6 courses and all patients were followed up for 2 months to 2 years.Better prognosis was seen in them.Conclusions There is significant difference between acute intracerebral hemotoma type and other types in children cerebral paragonimiasis,the former one has shorter course of disease and present more severe,are easy to be misdiagnosed through imaging examination,aggressive surgical treatment and standardized drug therapy are needed to achieve better therapeutic efficacy and prognosis.