椎管内与胸腔沟通包虫病1例并文献复习

Diagnosis and treatment of chest and spinal canal communicating echinococcosis (report of 1 case and review of literature)

目的探讨椎管内与胸腔沟通包虫病的临床特点及诊疗方法。方法回顾分析1例椎管内与胸腔沟通包虫病患者的临床资料;并对相关文献进行复习。结果本例患者临床表现为脊髓压迫症状;MRI检查示,胸椎椎管内占位,并与右侧胸腔沟通,右侧胸腔巨大占位;经手术完全切除病灶;术后病情好转。以往文献报道均是脊椎包虫病经骨质破坏,突入椎管压迫脊髓导致相应脊髓功能障碍,未见脊椎骨质完整的椎管内与胸腔沟通的包虫病的相关报道。结论疫源地区发现椎管内或与胸腔等邻近沟通的特殊占位病灶,诊断需考虑包虫病的可能。对已出现脊髓压迫症状患者应实施手术治疗;解除脊髓压迫,并防止术中污染,是取得良好疗效的关键。

Objective To report a rare case with chest and spinal canal communicating echinococcosis.Methods The clinical data of 1 rare case with chest and spinal canal communicating echinococcosis was analyzed retrospectively and the related literature was reviewed.Results The patient presented with symptoms of spinal cord compression.MRI examination showed that the thoracic vertebral canal was occupied and communicated with the right thoracic cavity which was largely occupied.Complete surgical resection of the lesion led his condition improved after the operation.Surgical treatment was the main treatment of the disease.The relevant literature reported that spinal echinococcosis was with bone destruction.Spinal canal compression of spinal cord led to corresponding spinal cord dysfunction.The spine bone full communication with the chest of intra-spinal canal echinococcosis was not reported before.Conclusions If the spinal canal or nearby connected special placeholder lesions,such as chest,is found in the source region,hydatid should be considered.Patients with spinal cord compression symptoms are given surgical treatment.To remove and prevent intraoperative spinal cord compression pollution is the key to achieve good curative effect.