102例颅内包囊虫的手术治疗

Surgery of cerebral hydatid cysts ： 102 cases experience

目的探讨颅内包囊虫手术治疗的疗效和临床分型。方法回顾分析102例颅内包囊虫患者，男56例，女46例，中位16．8岁。细粒棘球蚴采用注水漂浮法完整摘除，泡状棘球蚴行肿块完整切除术。结果细粒棘球蚴患者中94例完整摘除，包括8例破溃后摘除，其中3例因过敏性休克死亡，5例采用阿苯哒唑脂质体治疗有效。泡状棘球蚴8例经手术全切，仅有1例长期生存，其余7例因并发肝脏泡状棘球蚴反复复发而死亡。结论细粒棘球蚴和泡状棘球蚴只有完整摘除和切除，患者才可得治愈。手术中一定要操作仔细轻柔以免破溃导致过敏性休克并发感染死亡或包囊虫复发。

Objective To discuss effect and clinical classification of 102 patients with cerebral hydatid cysts retrospectively. Method According to hallmark of clinical manifestation and imaging, hydatid cysts were divided into two types,one is echinococcosis granulosa,the other is echinococcsis muhilocularies. Echinococeosis granulosa were totally resccted by dowling method and cehinoeoeesis muhilocularies were also totally ablated. Results Of 102 patients ,94 patients were totally removed without cysts rupture, 8 cases were totally with cysts rupture, and 3 eases were died of allergic shock with infection. Five cases relapsed and reoperated. Conclusions Despite any kinds, patients can be cured when the hydafid cysts were totally removed. But suegeons should avoid allergic shock by en block resection without cysts rupture.