成人脑棘球蚴病的诊断和治疗72例临床分析

Diagnosis and Management of Adult Cerebral Echinococcosis

目的探讨成人脑棘球蚴病的诊断方法和治疗效果。方法回顾性分析新疆医科大学第一附属医院神经外科2000—2012年诊疗的成人颅内棘球蚴病患者临床资料,包括传染源接触史、人口学特点、诊断方法、治疗模式以及治疗效果。结果 72例患者全部为成人,其中细粒棘球蚴病64例,多房棘球蚴病8例。68例患者行手术+阿苯达唑治疗,4例行单纯阿苯达唑治疗。9例术中破裂(12.5%),7例(9.7%)复发,2例(2.8%)死亡。9例(12.5%)术后留有永久性功能损害。结论手术仍然是成人脑棘球蚴病的首选治疗方式,术中破溃的患者或不能手术的患者,药物治疗也是有效的。尽管随着影像技术、手术技术、新型药物的进展,成人脑棘球蚴病的有效率大大提高,较高的复发率和致残率仍然不容忽视。

Objective To discuss diagnosis and therapy of adult cerebral echinococcosis.Methods The data of patients with cerebral echinococcosis treated from 2000 to 2012 were analyzed retrospectively, including：source of infection,demographic characteristics,diagnostic method,treatment and effect.Results Of 72 adult patients,64 were cystic echinococcosis and 8 were alveolar echinococcosis.Sixty-eight patients were operated plus albendazole,4 were treated with albendazole only.The cysts ruptured in 9（12.5%）cases during the procedure.Recurrence was found in 7 patients postoperatively.Two patients died.Nine patients （12.5%）had permanent neurofunction deficit.Conclusion Surgery is still the first choice and the effective method for cerebral echinococcosis.Despite the quick development in imaging and operative techniques,cerebral echinococcosis still has high morbidity and recurrence rate.