脑囊虫病合并脑积水的影像学诊断与外科手术治疗

Diagnosis and Surgical Treatment of Patients with Hydrocephalus Brain Cysticercosis

目的:探讨脑积水型脑囊虫病的诊断与外科手术治疗效果。方法:对诊断明确的73例脑积水型脑囊虫病患者实施了脑室或脑池囊虫摘除术,术后进行抗脑囊虫病治疗。结果:其中13例脑积水症状改善效果不佳,二次行脑室-腹腔分流术,60例手术均获成功。术后均未出现新的神经损害症状,脑室恢复正常。结论:影像检查是对脑积水型脑囊虫病做出正确诊断的重要依据,积极手术切除脑囊虫,解除梗阻性脑积水术后再进行抗囊虫治疗,必要时再行脑室腹腔分流手术,临床效果明确安全。

Objective： To investigate the diagnosis and surgical treatment effect of hydrocephalic neurocysticercosis. Methods：A retrospective analysis.the diagnosis and surgical treatment process of 73 cases neurocystieercosis with hydrocephalus confirmed by surgical operation and clinical pathology. Results ：According to epidemiology, patient history, clinical manifestations and CT, MRI examination and laboratory examination of 73 cases hydrocephalic neuro eysticercosis, 67 cases could make a correct diagnosis, but six cases of atypical always easily misdiagnosed,After the rechecked MR1 and laboratory made a clear diagnosis. 73 cases neuroeysticercosis was removed from cerebral ventricle and cistern by surgery, postoperative anti-brain cysticercosis treatment, 13 cases of them symptom improvement effect was not good, made ventricles of the brain-abdominal cavity bypass, The surgery attains successfully, new symptoms of nervous lesion symptom did not happen after the surgery, cerebral ventricle return to normal. Conclusion ：Making a correct diagnosis should be based on epidemiology, patient history, clinical manifestations, neuroimaging and laboratory examination, earring out a comprehensive analysis. Some non-typical make misdiagnosed easily, rechecking MRI and laboratory examination can help the differential diagnosis; Hydrocephalus neurocysticercosis, once a clear diagnosis, surgical operation should be made actively, take out of neurocysticercosis, relief obstructive hydrocephalus and than drug treatment. If necessary, make the ventriculoperitoneal shunt. Clinical effects of the therapy is manifestation and security.