CAJ | 학술논문

目的：探讨颅内寄生虫病的外科手术指证及技巧。方法回顾性分析了40例颅内寄生虫病患者的手术治疗过程,其中单发脑实质病灶16例,脑室病灶6例,鞍区病灶1,颅内多发病灶17例,同时合并脑积水5例,根据颅内寄生虫病灶的不同位置选择不同的手术方式摘除颅内病灶或行脑室腹腔分流术。结果38例患者术后症状得到明显缓解,2例死亡。35例切除了颅内寄生虫病灶的患者,病理报告均证实为寄生虫,其中21例囊虫,12例包虫,2例血吸虫。18例术后随访6~24个月,未见新增病灶。结论外科手术是治疗颅内寄生虫病有效方法。术前应做好充分准备,尤其是在考虑脑室病灶为包虫时,应绝对保障囊壁的完整性,避免出现囊液外漏播散导致术后出现严重的炎症反应、死亡。
목적：탐토로내기생충병적외과수술지증급기교。방법회고성분석료40례로내기생충병환자적수술치료과정,기중단발뇌실질병조16례,뇌실병조6례,안구병조1,로내다발병조17례,동시합병뇌적수5례,근거로내기생충병조적불동위치선택불동적수술방식적제로내병조혹행뇌실복강분류술。결과38례환자술후증상득도명현완해,2례사망。35례절제료로내기생충병조적환자,병리보고균증실위기생충,기중21례낭충,12례포충,2례혈흡충。18례술후수방6~24개월,미견신증병조。결론외과수술시치료로내기생충병유효방법。술전응주호충분준비,우기시재고필뇌실병조위포충시,응절대보장낭벽적완정성,피면출현낭액외루파산도치술후출현엄중적염증반응、사망。
Objective To investigate the operation indications and skills of parasitic encephalopathy. Methods A retro-spective analysis of 40 patients who were hospitalized in our department from january 2004 to December 2014 with parasitic en-cephalopathy was performed. 16 cases were brain single occupying. 6 cases were ventricles lesions,1 cases were sellar region le-sions,17 cases were multiple intracranial lesions including 5 cases with hydrocephalus. all of 40 cases were resected by surgery. According to the different position of intracranial lesions parasites choose different ways of operation to remove intracranial lesions or ventricle peritoneal shunt. Results 38 cases of patients treated with operation were successfully performed,whose symptoms of intracranial hypertension were immediately relieved after operative procedures,except for 2 patients died. 35 patients with pathologi-cal results confirmed parasitic encephalopathy,including 21 cases of cysticercosis, 12 cases of hydatid, 2 cases of Schistosome. There were no nervous lesion newly found for 6- 24 months postoperative follow-up with 18 patients. Conclusion Surgery was an effective method in treatment of intracranial parasitic Encephalopathy. It should be fully prepared before surgery,especially in con-sideration of intrawentricular lesions for hydatid. It was very important to guarantee the integrity of the cyst wall,because of the cystic fluid extravasation,patients may be died.