CAJ | 학술논문

目的：总结脑囊虫病的手术治疗方法，并分析治疗效果。方法脑囊虫病患者28例，采用开颅显微镜下囊虫摘除术治疗6例、脑室-腹腔分流术（ VP）治疗6例、第三脑室底造瘘术（ ETV）治疗14例、单纯行内镜下脑室囊虫摘除2例。术后随访，观察治疗效果。结果术后出现颅内感染2例、头痛6例、一过性动眼神经麻痹2例、硬膜下积液1例、脑积水加重1例。出院后23例经12～84个月随访，临床症状、体征改善19例，无变化3例，死亡1例。采用开颅显微镜下囊虫摘除及单纯行内镜下脑室囊虫摘除患者的临床症状、体征均改善。行VP治疗的6例患者中，2例因分流管梗阻需再次手术治疗；行ETV治疗的14例患者中，6例因脑积水导致颅内压增高，症状缓解不理想，再次行VP治疗；再次治疗后症状、体征均改善。结论脑囊虫病根据囊虫部位及临床、影像学表现个性化选择手术治疗方案的治疗效果较好。
목적：총결뇌낭충병적수술치료방법，병분석치료효과。방법뇌낭충병환자28례，채용개로현미경하낭충적제술치료6례、뇌실-복강분류술（ VP）치료6례、제삼뇌실저조루술（ ETV）치료14례、단순행내경하뇌실낭충적제2례。술후수방，관찰치료효과。결과술후출현로내감염2례、두통6례、일과성동안신경마비2례、경막하적액1례、뇌적수가중1례。출원후23례경12～84개월수방，림상증상、체정개선19례，무변화3례，사망1례。채용개로현미경하낭충적제급단순행내경하뇌실낭충적제환자적림상증상、체정균개선。행VP치료적6례환자중，2례인분류관경조수재차수술치료；행ETV치료적14례환자중，6례인뇌적수도치로내압증고，증상완해불이상，재차행VP치료；재차치료후증상、체정균개선。결론뇌낭충병근거낭충부위급림상、영상학표현개성화선택수술치료방안적치료효과교호。
Objective To summarize the surgical treatment methods of the intracranial neurocysticercosis and to ana -lyze the therapeutic effect .Methods Twenty-eight patients with intracranial neurocysticercosis who received surgeries were analyzed , including 6 cases of microscopic resection of cysticercosis , 6 cases of ventriculoperitoneal ( VP) shunt , 14 cases of third ventriculostomy ( ETV) and 2 endoscopic resection of cysticercosis .All patients were followed up and the therapeutic effect was observed .Results The perioperative complications were found , including 2 cases of intracranial in-fection, 6 cases of headache , 2 cases of transient oculomotor paralysis , 1 case of subdural effusion and 1 case of heavy hy-drocephalus .After a follow-up of 23 patients for 12-84 months, the clinical symptomatic improvement occurred in 19 cases, no change in 3 cases and 1 case of death .The clinical symptoms and signs were improved in patients who received micro-scopic resection of cysticercosis or simple endoscopic resection of cysticercosis .In the 6 patients receiving VP , 2 patients had to receive another operation because of shunt obstruction .In the 14 patients receiving ETV , 6 patients received VP shunts suffering from deterioration of hydrocephalus symptoms , and the symptoms and signs were improved after the second treatment.Conclusions According to the area of intracranial neurocysticercosis , clinical and imaging manifestations , the personalized choice of the surgical methods has the good effect .